Epileptic seizures in systemic lupus erythematosus
Epileptic seizures in systemic lupus erythematosus
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DOI：
10.1212/01.wnl.0000144178.32208.4f
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发表时间：
2004-11-23
期刊：
影响因子：
9.9
通讯作者：
Costallat, LTL
中科院分区：
文献类型：
--
作者：
Appenzeller, S;Cendes, F;Costallat, LTL
目的：探讨系统性红斑狼疮（SLE）患者癫痫发作的频率及危险因素。方法：对519例连续SLE患者进行了研究，随访时间为4 ~ 7.8年。确定与SLE患者急性和复发性癫痫发作相关的危险因素的类型和频率。结果：60例（11.6%）癫痫发作的患者被确定。癫痫发作发生在SLE症状发作时19例（31.6%），发病后41例（68.3%）。60例患者中53例（88.3%）有急性症状性癫痫发作，7例（11.7%）有反复发作。与SLE发作时急性癫痫发作相关的变量为卒中（p=0.0004）和抗磷脂抗体（p=0.0013）。随访期间的癫痫发作与肾炎（p=0.001）、抗磷脂抗体（p=0.005）和疾病发作时的癫痫发作（p=0.00001）相关。所有7例反复癫痫发作的患者均具有抗磷脂综合征和发作间期脑电图癫痫异常。结论：11.2%的系统性红斑狼疮（SLE）患者存在癫痫发作。抗磷脂抗体和卒中与SLE疾病发作时的癫痫发作有关。在随访期间，有肾闪辉、SLE疾病发作时癫痫发作和抗磷脂抗体的患者发生急性症状性癫痫发作的风险更大。癫痫发作复发发生在1.3%的患者，并与抗磷脂综合征。
Objective: To evaluate the frequency and risk factors of epileptic seizures in a large cohort of patients with systemic lupus erythematosus (SLE). Methods: Five hundred nineteen consecutive patients with SLE were studied, with follow-up ranging from 4 to 7.8 years. The type and frequency of risk factors associated with acute and recurrent epileptic seizures in SLE were determined. Results: Sixty (11.6%) patients with epileptic seizures were identified. Epileptic seizures occurred at the onset of SLE symptoms in 19 (31.6%) and after the onset of SLE in 41 of 60 (68.3%) patients. Fifty-three of 60 (88.3%) patients had acute symptomatic epileptic seizures, and 7 of 60 (11.7%) had recurrent epileptic seizures. Variables associated with acute epileptic seizures at SLE onset were stroke (p=0.0004) and antiphospholipid antibodies (p=0.0013). Epileptic seizures during follow-up were related to nephritis (p=0.001), antiphospholipid antibodies (p=0.005), and epileptic seizures at disease onset (p=0.00001). All seven patients who presented recurrent epileptic seizures had antiphospholipid syndrome and interictal epileptic abnormalities on EEG. Conclusions: Epileptic seizures were observed in 11.2% of systemic lupus erythematosus (SLE) patients. Antiphospholipid antibodies and stroke were related to epileptic seizures at SLE disease onset. Patients with renal flares, epileptic seizures at SLE disease onset, and antiphospholipid antibodies were at greater risk for acute symptomatic seizures during follow-up. Recurrence of epileptic seizures occurred in 1.3% of patients and was associated with antiphospholipid syndrome.