摘要
目的通过对以抽搐发作为首发症状的234例老年人癫痫的病因及临床特点的回顾性分析,完善对老年癫痫的认识,以利正确诊断及治疗。方法详细分析以抽搐发作为首发症状的234例老年人癫痫的病因、临床特点及预后情况,并进行总结。结果234例老年癫痫患者男性148例,女性86例,年龄60-82岁。222例有明确病因,分别为脑血管病132例,非酮症性糖尿病22例,脑外伤21例,颅内感染20例,颅内肿瘤12例,电解质及代谢紊乱13例,脑萎缩1例,急性心肌梗死1例;12例患者没有查到明确病因。临床表现为全面性发作115例,单纯性部分性发作32例,复杂部分性发作16例,部分继发全面性发作40例,癫痫持续状态28例,发作形式复杂多样3例;住院期间症状完全控制91例,发作次数减少118例,未控制20例,死亡5例。结论脑血管病、颅内感染、非酮症性糖尿病和脑外伤是老年人癫痫发病的主要原因。发病形式以全面性发作最常见。对于老年人,还应注意少见的病因如心肌梗死等。老年人癫痫预后相对良好。
Objective To improve the understanding of epilepsy in elderly in order to facilitate the correct diagnosis and treatment by a retrospective analysis of etiology and clinical features.Method The etiology,clinical features and prognosis of 234 patients were analyzed in detail and summarized.Result 148 males and 86 females were included,aged from 60 to 82 years.222 cases had a clear cause,namely,132 cases with cerebrovascular disease,non-ketotic diabetes mellitus in 22 cases,21 cases with traumatic brain injury,intracranial infection with 20 cases,12 cases with intracranial tumors,electrolyte and metabolic disorders in 13 cases,cerebral atrophy in 1 case,and acute myocardial infarction in 1 case.12 patients were not found a clear cause.The clinical manifestations consisted of GTCS in 115 cases,simple partial seizures in 32 cases,complex partial seizures in 16 cases,secondary GTCS in 40 cases,status epilepticus in 28 cases,and complex and diverse forms of attack in 3 cases.There were 91 patients＇symptoms completely controlled during hospitalization.118 cases＇seizure frequency reduced,while 20 cases hadn＇ t controlled and 5 died.Conclusion Cerebrovascular disease,intracranial infections,non-ketotic diabetes and brain injury are the main reasons of epilepsy in the elderly.The most common form is GTCS.Attentions should be paid to some rare causes,such as myocardial infarction,etc.The elderly with epilepsy have a relatively good prognosis.
出处
《中风与神经疾病杂志》
CAS
CSCD
北大核心
2010年第2期164-166,共3页
Journal of Apoplexy and Nervous Diseases
关键词
癫痫
老年人
Epilepsy
Elderly
