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Neurology:瑞典万人研究发现,颅内感染后,癫痫发病率明显增加

2021-01-02 MedSci原创 MedSci原创

颅内感染后,癫痫发病率明显增加

 
后天性癫痫可以发生在任何脑部疾病中,国际抗癫痫联盟强调从癫痫病因学(International League Against Epilepsy, ILAE)的角度进行分类。有研究者基于1988年至2016年间发表的关于脑部感染后癫痫的文献进行了荟萃分析,估计发达国家颅内感染后,大约有8%的人会癫痫发作,在资源匮乏国家的,发病率更高。感染后的癫痫风险,因感染类型或成人、儿童不同而不同。据报道,1990-2001年和1995-2013年间,分别有24% 和46% 的疱疹性脑炎后幸存者受到癫痫的影响,1935-1981年或1982-2016年间的研究分别有27% 和32% 的脑脓肿幸存者受到癫痫的影响。在1935-1981年的细菌性脑膜炎患者中,有2% 或13% 的人患有癫痫,这取决于早期癫痫发作的情况。急性症状性发作、癫痫持续状态、 ICU 住院、脑电图异常和神经放射学损害是脑炎或脑膜炎后癫痫的危险因素。
 
瑞典哥德堡大学的Johan Zelano等人,通过回顾性研究,分析了瑞典成年人脑部感染后癫痫的危险因素和危险因素。
他们基于瑞典国家病人注册系统,在2000-2010年期间,纳入了所有年龄大于18岁但没有癫痫病史的患者,他们因为脑部感染接受了住院治疗,每个接触者有三个年龄和性别匹配的对照组(n = 12101个接触者和36228个对照者)。通过 Cox 回归分析,计算不同脑部感染后 Kaplan-Meier 癫痫发作的危险因素。随访病人直到2017年底。
 
结果显示:脑膜炎患者10年内癫痫发生率为5.9% (95% CI: 5.5-6.3) ,对照组为1.2% (95% CI: 1.0-1.4) ,蜱媒脑炎(tick borne encephalitis)患者为1.7% (95% CI: 0.7-2.7) ,细菌性脑膜炎患者为4.1% (95% CI: 3.3-4.9) ,细菌性脑膜炎患者为26.0% (95% CI: 21.5-30.5) ,脑脓肿患者为30.2% (95% CI: 27.1-33.3)。在 Cox 回归分析中,紧急入院治疗和机械通气是癫痫的危险因素。
 
这个研究的主要意义在于,成人的多种脑部感染后癫痫发作较为常见。感染的类型、严重程度和在急性期引起癫痫发作的倾向会影响后期的癫痫发作风险。

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    2021-11-15 yinhl1978
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    2021-01-04 Jessica

    脑部感染后,癫痫发作的机率会增加!

    0

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    2021-01-03 吴教授

    学习了

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