在成年人第一次状态后,远程和耐药性
Niccolò Orlandi1,2, Giada Giovannini1, Maria Cristina Cioclu2
1Neurology Unit, Ospedale Civile, Azienda Ospedaliera-Universitaria di Modena, Modena, Italy.
在第一个状态 (SE) 之后,远程未引起的发作 (RS) 的长期风险是中等的,大多数发生在两年内. 诸如脑损伤和非性SE等特定因素增加RS和耐药性的风险.
科学领域:
- 神经学 神经学
- 发病学 (Epileptology) 是一个专业的学科.
- 临床神经科学 临床神经科学
背景情况:
- 在状态 (SE) 之后的长期结果仍然不完全理解.
- 调查远程未引起的发作 (RS) 和耐药性 (DRE) 的发生率对于管理SE幸存者至关重要.
研究的目的:
- 确定RS和DRE在患者队列中的发病率,这些患者经历了首次SE.
- 为了确定RS和DRE在SE之后的发展的预测因素.
主要方法:
- 一项回顾性,观察性,单心研究包括279名首次出现SE的成年患者 (≥14岁).
- 卡普兰-梅尔分析评估了发作自由概率; 考克斯回归确定了结果预测因素.
- 数据来自意大利莫德纳学术医院 (2013年9月至2022年3月).
主要成果:
- 20.4%的患者 (57/279) 患有RS,其中81%发生在SE后2年内.
- 更高的RS风险与结构性大脑损伤,进展性症状病因和非性SE演变有关.
- 32%的患者 (18/57) 患有DRE,与超耐火性和非性SE相关.
结论:
- 第一次SE后RS的风险是中度的,主要发生在两年内.
- 特定的病因和SE半学,特别是非性进化,是RS和DRE的关键驱动因素.
- 治疗超强性和非性SE演变是DRE发展的重要预测因素.
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