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老年癫痫患者临床特征分析

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目的 分析老年癫痫患者的病因、临床特征及抗癫痫发作药物(anti-seizure medications,ASM)选择.方法 收集 2020 年 6 月至 2023 年 4 月就诊于宁夏医科大学总医院神经内科门诊的 313 例老年癫痫患者病历资料,回顾性分析患者病因、脑电图(electroencephalogram,EEG)及ASM的选择,总结其病因构成及ASM应用情况.结果 205 例(65.5%)有明确病因,其中脑卒中为最常见病因(54.1%,111/205),其次为头部外伤(29.8%,61/205).65~<75 岁组、75~<85 岁组病因差异均有统计学意义(P均<0.001),≥85 岁组病因分布差异无统计学意义(P>0.05).199 例行EEG检查,其中 165 例(82.9%)有痫样放电,34 例(17.1%)正常.131 例患者颅脑MRI和(或)CT可见病灶,其中 86 例(65.6%)病灶累及皮质区.不同年龄组痫样放电情况、颅脑MRI和(或)CT病灶情况差异有统计学意义(P均<0.05).老年癫痫患者的主要伴随疾病为高血压.295 例(94.2%)患者接受了ASM治疗,其中应用单种ASM为 185 例(62.7%),包括应用新型ASM为 111 例(60.0%)、传统ASM为74 例(40.0%);ASM联合治疗 110 例(37.3%);18 例(5.8%)患者未应用ASM.结论 老年癫痫的主要病因为脑卒中,EEG阳性率高.老年癫痫患者伴随疾病主要为高血压,ASM治疗以新型单药为主.
Clinical Characteristics of Elderly Individuals with Epilepsy
Objective To a nalyz e the etiology,clinical characteristics and the selection of anti-seizure medications(ASM)of elderly individuals with epilepsy(EIWE).Methods A total of 313 EIWE,who visited the Department of Neurology of General Hospital of Ningxia Medical University from June 2020 to April 2023 were collected.The etiology of epilepsy,electroencephalogram(EEG)results,selection of ASM were retrospectively analyzed,and the composition of the etiology and the ASM application were summarized.Results A total of 205(65.5%)cases had clear causes,with stroke being the most common cause(54.1%,111/205 cases),followed by brain trauma(29.8%,61/205 cases).The EIWE in 65-<75 years old group were mainly due to unknown causes(P<0.05),and the others in 75-<85 years old group were mainly due to stroke(P<0.05).There was no statistically significant difference in the distribution of causes among the≥85 years old group(P>0.05).199 cases underwent EEG examination,of which 165(82.9%)cases had epileptiform discharges and 34(17.1%)cases were normal(P<0.05).131 individuals'brain MRI and(or)CT showed lesions,of which 86(65.6%)cases involved the cortex.There were statistically significant differences in epileptiform discharge,cranial MRI and/or CT lesions among different age groups(P all<0.05).The main accompanying disease for EIWE was hypertension.295(94.2%)individuals received ASM treatment,including 185(62.7%)cases with single ASM,consisting of 111(60.0%)cases with new ASM and 74(40.0%)cases with traditional ASM;110(37.3%)cases were treated with two and more kinds of ASM;18(5.8%)individuals did not use ASM.Conclusion The main cause of elderly epilepsy is stroke,with a high positive rate of EEG.The main accompanying disease in elderly epilepsy patients is hypertension,and the treatment of ASM mainly relies on new monotherapy.

elderly individuals with epilepsyetiologyanti-seizure medications

贾晓丹、李思慧、许贤瑞、刘强、王旭、谭波飞、张庆

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宁夏医科大学,银川 750004

宁夏医科大学总医院神经内科,宁夏医科大学第一临床医学院,宁夏神经系统疾病临床医学研究中心,银川 750004

老年癫痫 病因 抗癫痫发作药物

2024

宁夏医科大学学报
宁夏医科大学

宁夏医科大学学报

CSTPCD
影响因子:0.84
ISSN:1674-6309
年,卷(期):2024.46(7)