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的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。列出的机构是 研究中心，而研究中心不一定是研究者所在的机构。 对于首次发生在轻度急性感染性疾病（非发热性疾病惊厥）背景下的非发热性惊厥，人们知之甚少，因为这些患者传统上被排除在发热性和无端惊厥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。 仅发表了两项系统性研究（均为回顾性）：一项在新加坡进行，另一项由我们的研究小组进行（Zerr et al. Epilepsia 2005;46：952-55）。 这两项研究的结果表明，首次非发热性疾病癫痫发作的发生频率与首次无端癫痫发作的发生频率相同，腹泻是伴随非发热性疾病癫痫发作的疾病的特征，其发生频率高于发热性癫痫发作，这表明特定病原体发挥了作用。 需要一项前瞻性研究来：1）证实上述发现，2）探索无热性惊厥的病毒病因，3）描述无热性疾病惊厥的预后。 为此，我们提出了一个前瞻性的试点研究。 我们将入组120例首次因惊厥（发热、非发热性疾病或无诱因）就诊于艾德的患者。 将对人体标本进行各种病毒病原体检测。 将对受试者后续癫痫发作进行5年随访。 本研究的数据1）将为临床医生提供管理非发热性疾病癫痫发作患者的指导和背景，2）将作为NIH应用的试点数据，通过多中心研究进一步研究这些问题，3）有可能告知我们对癫痫发作发病机制的理解。

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.