VIRAL PATHOGENS AND FIRST TIME SEIZURES IN THE SETTING OF ILLNESS

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 首次非热性癫痫发作发生在轻度急性传染病(非热性疾病癫痫)的背景下，人们知之甚少，因为这些患者传统上被排除在关于热性和无缘性癫痫的大型流行病学研究之外，因为它们不容易使用国际分类系统进行分类。 只发表了两项系统研究(都是回顾性的)：一项设在新加坡，另一项由我们的研究小组进行(Zerr等人)。癫痫2005；46：952-55)。这两项研究的结果都表明，第一次非发热性癫痫发作的频率与第一次无缘无故癫痫发作的频率一样高，而腹泻是非发热性疾病癫痫发作的特征，比热性癫痫发作更频繁，这表明特定的病原体发挥了作用。 需要进行前瞻性研究：1)证实上述发现，2)探讨非热性惊厥的病毒病因，3)描述非热性惊厥的预后。为此，我们建议进行一项前瞻性的试点研究。我们将招募120名首次出现癫痫的患者：发烧、非发热性疾病或无缘无故。人体样本将接受各种病毒病原体的检测。受试者将被跟踪5年以进行随后的癫痫发作。这项研究的数据1)将为临床医生在处理非发热性疾病癫痫患者时提供指导和背景，2)将作为NIH应用程序的试点数据，通过多中心研究进一步研究这些问题，以及3)有可能告知我们对癫痫发病机制的理解。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Little is known about first-time nonfebrile seizures occurring in the setting of mild acute infectious illness (nonfebrile illness seizures) as these patients have traditionally been excluded from large epidemiological studies of both febrile and unprovoked seizures as they are not easily classified using the international classification system. Only two systematic studies (both retrospective) have been published: one set in Singapore and one performed by our research group (Zerr et al. Epilepsia 2005;46:952-55). Results from both studies suggest that first-time nonfebrile illness seizures occur as often as first-time unprovoked seizures and that diarrhea characterizes the illness accompanying nonfebrile illness seizures more frequently than febrile seizures, suggesting that specific pathogens play a role. A prospective study is needed to: 1) confirm the above findings, 2) explore viral etiologies of nonfebrile seizures, and 3) describe the prognosis of nonfebrile illness seizures. To this end we propose a prospective pilot study. We will enroll 120 patients who present to the ED with first-time seizures: febrile, nonfebrile-illness, or unprovoked. Human specimens will be tested for a variety of viral pathogens. Subjects will be followed for subsequent seizures for 5 years. Data from this study 1) will provide clinicians with guidance and context when managing patients with nonfebrile illness seizure, 2) will serve as pilot data for an NIH application to further study these questions via a multicenter study, and 3) has the potential to inform our understanding of the pathogenesis of seizures.