老年性癫痫病因和临床特点分析

发布时间：2018-04-16 10:24

本文选题：老年 + 癫痫　；参考：《重庆医科大学》2017年硕士论文

【摘要】：目的研究老年性癫痫的病因、临床表现、辅助检查、治疗及预后。方法以“癫痫”和/或“发作”为检索词,从重庆医科大学附属第一医院病案室调取2011年7月到2017年2月住院病人中出院诊断包含“癫痫”或/和“发作”字样的患者信息,筛选出年龄≥60岁的患者,详细分析所筛选的老年性癫痫患者的病历资料,包括基本资料(姓名、性别、年龄、住院科室)、病因、临床表现、辅助检查(包括脑电图、头颅CT/MRI、生化检查)、用药,长期住院患者通过仔细阅读病历资料分析药物疗效及副反应,其余患者通过电话随访进行记录。结果96例(79.34%)有明确病因,常见病因包括脑血管疾病(59.38%),颅内肿瘤(13.54%),中枢神经系统感染(8.33%),脑外伤(5.20%),急性代谢或毒性因素(11.46%)。部分性发作71例(58.68%),其中复杂部分性发作54例(44.63%);全面强直-阵挛发作15例(12.40%);强直性发作14例(11.57%);癫痫持续状态17例(14.05%);不典型发作4例(3.31%)。丙戊酸钠、左乙拉西坦是最常用的药物。82例患者治疗有效(97.62%),88.10%患者仅单药治疗即有效。结论老年性癫痫大多存在明确病因,其中脑血管疾病最常见,颅内肿瘤、中枢神经系统感染、脑外伤为常见病因,急性代谢或毒性因素不容被忽视。部分性发作为最常见的发作类型,尤其以复杂部分性发作最多见。多数患者仅使用单药治疗可以减少癫痫发作,仅少部分患者需要两种或两种以上药物联合治疗。
[Abstract]:Objective to study the etiology, clinical manifestation, adjuvant examination, treatment and prognosis of senile epilepsy.Methods using "epilepsy" and / or "seizure" as the key words, the information of the patients who had been discharged from the first affiliated Hospital of Chongqing Medical University from July 2011 to February 2017 to diagnose the patients with the words "epilepsy" or / and "seizure" were collected from the medical records room of the first affiliated Hospital of Chongqing Medical University.Patients aged more than 60 years were selected. The medical records of the selected patients with senile epilepsy were analyzed in detail, including basic data (name, sex, age, hospitalization, etiology, clinical manifestations, auxiliary examinations (including electroencephalogram, EEG).CTR / MRI, biochemical examination, medication, long-term inpatients through careful reading of medical records analysis of drug efficacy and side effects, the rest of the patients were recorded by telephone follow-up.Results 96 cases (79.34) had definite etiology. The common causes included cerebrovascular disease (59.38), intracranial tumor (13.54), central nervous system infection (8.33%), brain injury (5.20%), acute metabolic or toxic factors (11.46%).There were 71 cases of partial seizure, 54 cases of complex partial seizure, 15 cases of total tonic-clonic seizure, 14 cases of tonic seizure, 14 cases of tonic attack, 17 cases of epileptic status and 14.05%, 4 cases of atypical seizure, and 3.31% of the total tonic-clonic seizure.Valproate sodium, levoethylacetam is the most commonly used drug. 82 patients with effective treatment of 97.62% of the patients with 88.10% of the drug alone is effective.Conclusion the most common causes of senile epilepsy are cerebrovascular diseases, intracranial tumors, central nervous system infection and brain trauma. The acute metabolic or toxic factors should not be ignored.Partial onset is the most common type of attack, especially complex partial attack.Only a few patients need two or more drugs to treat epilepsy.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R742.1

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