【作者】 韩玉香；

【导师】 迟兆富；

【作者基本信息】 山东大学 ， 神经病学， 2007， 硕士

【摘要】 目的：通过对148例接受正规药物治疗的成人癫痫病例的研究，分析成人癫痫的临床特点，探讨其病因、发作类型、辅助检查及治疗方面的问题。方法：回顾性分析148例于2006年2月至2007年2月在山东大学齐鲁医院神经内科门诊及病房确诊为癫痫的患者。患者均接受正规药物治疗至少6个月，最小年龄18岁，采集所有患者的年龄、性别、病因、临床表现、辅助检查结果、口服药物种类及近期发作情况等临床资料，并应用统计学方法分析年龄、病因、发作类型、影像学检查阳性率、药物疗效等方面的差异。结果：1．获得较为明确病因的共52例，占全部患者的35.1％；随着年龄的增加病因明确者的比例增大，即症状性癫痫比例增大。2．症状性癫痫患者的主要病因为颅脑感染、脑血管病、颅脑外伤、先天发育异常、颅脑肿瘤、围产期损伤等，不同年龄阶段具体病因分布不同。3．120例患者行EEG检查，检出异常者85例；91例患者行颅脑CT检查，检出异常者40例；25例患者行颅脑MRI检查，检出异常者12例。4．成人癫痫表现为多种发作类型，以全身性强直阵挛发作(GTCS)、复杂部分性发作(CPS)、简单部分性发作(SPS)多见。5．成人癫痫患者中最常用药物为苯妥英钠(PHT)、卡马西平(CBZ)、丙戊酸钠(VPA)；癫痫药物在非症状性癫痫组控制有效率为81.2％，症状性癫痫组的控制有效率为53.8％，存在统计学差异。6．新型抗癫痫药物治疗癫痫显示了良好的疗效与耐受性。结论：1．发病年龄与病因的关系：不同年龄组症状性癫痫的比例不同，病因不同，随着年龄的增长，症状性癫痫比例增加。2．感染、脑血管病、外伤、肿瘤、发育畸形等为成人癫痫患者的主要病因。3．通过辅助检查，本组病例中症状性癫痫占总数的35.1％，非症状性癫痫占64.9％：影像学检查在诊断不明确的病例中应作为常规检查工具。4．GTCS、CPS、SPS为成人癫痫患者主要发作类型。5．症状性癫痫与非症状性癫痫患者药物治疗效果存在统计学差异。6．新型抗癫痫药物治疗癫痫显示了良好的疗效与耐受性。更多还原

【Abstract】 Objective: to investigate the characteristics of the adult epilepsy, to obtain some knowledge about the etiological factors, auxiliary examination, seizure type and drug therapy.Method: 148 patients (age>=18years) who were diagnosed epilepsy in QiluHospital of Shandong University from February 2006 to February 2007 were enrolled in the study. The detailed information about these patients were collected and analyzed.Results: (1) Among 148 patients, 52 patients were diagnosed as symptomaticepilepsy, and the rate of symptomatic epilepsy grows as the age of the patients grows. (2) The main etiologies of adult epilepsy are infection of CNS, CVD, cerebral trauma and so on. (3) 120 patients do the EEG examination and 85 patients have positive finding; 91 patients have CT examination and 40 patients have positive finding; 25 patients have MRI examination and 12 patients have positive finding. (4) GTCS、CPS、SPS are the main seizure types of adult epilepsy.(5)PHT、CBZ、VPA are the most commonly used antiepileptic drugs in adult epilepsy, the drug efficiency is different in symptomatic epilepsy and non-symptomatic epilepsy.(6)New antiepileptic drugs such as TPM、LTG、OXC are efficient.Conclusion: (1) The rate of the symptomatic epilepsy grows as the age grows.(2) Infection of the CNS、CVD、trauma、tumor are the main abnormal findings.(3) CT/MRI should be carried in adult epileptic patients.(4) GTCS、CPS、SPS are the main seizure types in adult epilepsy.(5) The efficiency of the drug therapy is better in non-symptomatic epilepsy when compared with symptomatic epilepsy.(6) New antiepileptic drugs are efficient.更多还原