[Sudden unexpected death in epilepsy in children and adolescents].
[Sudden unexpected death in epilepsy in children and adolescents].
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发表时间：
2002-03
影响因子：
1.2
通讯作者：
B. Morentin;R. Alcaraz
中科院分区：
文献类型：
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作者：
B. Morentin;R. Alcaraz
前言癫痫猝死（SUDEP）是年轻癫痫患者死亡的重要原因。然而，它是相对未知的神经学家。目的分析青年人猝死（SD）原因中SUDEP的发生率及临床病理特征。患者和方法的观察性研究，所有SD由于SUDEP的人年龄在1 - 35岁之间发生在1991年和1998年在Bizkaia，其中医学法律的尸检。在所有病例中，均进行了全面尸检，并调查了既往临床病史。结果107例SD中8例（7.5%）为SUDEP所致。其中5人年龄在25至29岁之间，这是该年龄组最常见的死亡原因（22%）。其中6人被诊断为特发性癫痫，2人被诊断为创伤后癫痫。全身性惊厥发生率为75%。4名患者在独处时死亡。两名患者在死亡前几小时癫痫发作。尸检时，除两名创伤后癫痫患者外，未观察到脑结构变化。肺水肿是一个常见的发现。在50%的死亡患者中，化学毒理学研究表明没有他们所开药物的痕迹。结论尽管SD很少见，但SUDEP是年轻癫痫患者死亡的重要原因。与癫痫有关的暴力死亡在法医学中造成问题。虽然SUDEP的机制尚不清楚，但似乎有必要加强对这种疾病的医疗控制，特别是在年轻人中。
INTRODUCTION Sudden unexpected death in epilepsy (SUDEP) is an important cause of death in young epileptic patients. However, it is relatively unknown to neurologists. OBJECTIVE To analyze the frequency and clinicopathological characteristics of SUDEP as a cause of sudden death (SD) in young persons. PATIENTS AND METHODS An observational study of all SD due to SUDEP in persons aged 1 35 years occurring between 1991 and 1998 in Bizkaia, in whom medico legal autopsy was done. In all cases a full autopsy was done and the previous clinical history was investigated. RESULTS Eight of the 107 cases of SD (7.5%) were due to SUDEP. Five were aged between 25 and 29 years and in this age group it was the commonest cause of death (22%). Six had been diagnosed as having idiopathic epilepsy and two as having posttraumatic epilepsy. Generalized convulsions occurred in 75%. Four patients died when they were alone. Two patients had epileptic seizures hours before their death. At necropsy no structural changes were seen in the brain except in the two patients with posttraumatic epilepsy. Pulmonary oedema was a frequent finding. In 50% of the dead patients, chemico toxicological study showed there to be no trace of the drugs they had been prescribed. CONCLUSIONS Although SD is rare, SUDEP is an important cause of mortality in young epileptics. Violent death in relation to epilepsy causes problems in forensic medicine. Although the mechanisms of SUDEP are not clear, it would seem necessary to increase medical control of this disorder, especially in young people.