自身免疫性脑炎相关癫痫的临床研究

发布时间：2018-07-01 15:07

本文选题：自身免疫性脑炎 + 癫痫　；参考：《吉林大学》2017年硕士论文

【摘要】：目的:探讨自身免疫性脑炎相关癫痫的临床特征及预后情况。方法:对我院2014年12月至2016年8月间收治的43例伴有癫痫发作的自身免疫性脑炎患者一般情况、癫痫发生时间、发作特点、抗癫痫药使用及预后情况等临床资料进行回顾性分析。结果:43例患者中男性21例,女性22例,癫痫首发年龄以青中年居多。88.37%的患者癫痫发生于病程急性期,4.65%的患者为亚急性发作,6.98%的患者为慢性发作。51.26%的患者以癫痫为首发症状,76.74%的患者表现为部分继发全面性发作,39.53%的患者为复杂部分性发作,16.28%的患者为单纯部分性发作,9.30%的患者为全面强直阵挛性发作,34.88%的患者存在癫痫持续状态,其中33.33%为非惊厥持续状态,41.86%的患者存在2种及以上发作类型。癫痫发作表现形式多样,39.53%的患者伴有非痫性发作。80.56%的患者经抗癫痫治疗后发作得到明显控制,19.44%的患者无效,治疗有效组患者与无效组患者脑脊液抗体滴度、细胞数水平及蛋白量不存在显著差异(P=0.352,0.289,0.014,0.01)。40%的患者3月内停用抗癫痫药物,其中88.89%的患者随访至今已无癫痫发作。结论:自身免疫性脑炎相关癫痫常发生于起病2周内出现,51.16%的患者以此为首发症状,发作类型以部分继发全面性发作最多见,脑电图以颞区起源为主,41.86%的患者有2种及以上发作类型。80.56%的患者经抗癫痫治疗后发作得到有效控制,脑脊液抗体滴度、细胞数水平及蛋白含量不能作为评估自身免疫性脑炎相关癫痫预后的指标。
[Abstract]:Objective: to investigate the clinical features and prognosis of autoimmune encephalitis associated epilepsy. Methods: from December 2014 to August 2016, 43 patients with autoimmune encephalitis with epileptic seizures were treated in our hospital. The clinical data of antiepileptic drug use and prognosis were analyzed retrospectively. Results among 43 patients, 21 were males and 22 were females. The first onset age of epilepsy was mainly youth and middle age. 88.37% of the patients had epilepsy in the acute stage of the disease. 4.65% of the patients were subacute seizures, 6.98% of the patients were chronic seizures. 51.26% of the patients had epilepsy as the first symptom. 76.74% of the patients showed partial secondary comprehensive symptoms. 39.53% of the patients had complex partial seizures and 16.28% of the patients had partial seizures. 9.30% of the patients had generalized tonic-clonic seizures and 34.88% of the patients had status epilepticus. 41.86% of the patients with non-convulsive state had two or more seizure types. 39.53% of the patients with non-epileptic seizures and 80.56% of the patients had significantly controlled seizures after antiepileptic treatment, and 19.44% of the patients had no effect. The antibody titers of cerebrospinal fluid (CSF) in the effective group and the ineffective group were higher than those in the control group. There was no significant difference in cell number and protein content (P < 0. 352). 40% of the patients stopped taking antiepileptic drugs within 3 months. 88.89% of the patients had no seizure after follow up. Conclusion: autoimmune encephalitis associated epilepsy usually occurs in 51.16% of the patients within 2 weeks of onset. 41.86% of the patients with EEG mainly originated from temporal region. 80.56% of the patients with two or more seizure types were effectively controlled after antiepileptic treatment, and the antibody titer of CSF was obtained. Cell count and protein content can not be used to evaluate the prognosis of autoimmune encephalitis associated epilepsy.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R742

【相似文献】