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WHO/IEM/ILAE全球抗癫痫运动-宁夏农村癫痫的流行病学调查
目的调查宁夏农村癫痫病人的患病率、发病率和治疗缺口.方法利用统一的调查表,采用随机整群抽样的方法,对宁夏吴忠市利通区杨马湖乡逐家逐户进行癫痫流行病学问卷调查.结果共调查11 630人,确诊癫痫病人99人,癫痫病患病率8.51‰,发病率25.8/100000人.从未接受治疗的病人数45人,占45.5%,不正规治疗的病人数22人,占22.2%,正规治疗的病人数32人,占32.3%,1周内接受过西药治疗的人数19人,占19.2%.结论宁夏农村地区癫痫病患病率较高,治疗缺口较大.
作者单位：
宁夏医学院附属医院,宁夏,银川,750004
宁夏卫生学校,宁夏,银川,750004
宁夏吴忠市利通区医院,宁夏,吴忠,751100
北京市神经外科研究所,北京,100050
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万方数据电子出版社Seizure - European Journal of Epilepsy
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Seizure - European Journal of Epilepsy
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Seizure - European Journal of Epilepsy is an international journal owned by
(the largest member led epilepsy organisation in the UK). It provides a forum for papers on all topics related to epilepsy and seizure disorders.Seizure focuses especially on clinical and psychosocial aspects, but will publish papers on the basic sciences related to the condition itself, the differential diagnosis, natural history and epidemiology of seizures, as well as the investigation and practical management of seizure disorders (including drug treatment, neurosurgery and non-medical or behavioural treatments).The journal reflects the social and psychological burden and impact of the condition on people with epilepsy, their families and society at large, and the methods and ideas that may help to alleviate the disability and stigma, which the condition may cause. The journal aims to share and disseminate knowledge between all disciplines that work in the field of epilepsy.
Seizure - European Journal of Epilepsy is an international journal owned by
(the largest member led epilepsy organisation in the UK). It provides a forum for papers on all topics related to epilepsy and seizure disorders.Seizure focuses especially on clinical and psychosocial aspects, but will publish papers on the basic sciences related to the condition itself, the differential diagnosis, natural history and epidemiology of seizures, as well as the investigation and practical management of seizure disorders (including drug treatment, neurosurgery and non-medical or behavioural treatments).The journal reflects the social and psychological burden and impact of the condition on people with epilepsy, their families and society at large, and the methods and ideas that may help to alleviate the disability and stigma, which the condition may cause. The journal aims to share and disseminate knowledge between all disciplines that work in the field of epilepsy.
This journal supports the following content innovations
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Source Normalized Impact per Paper (SNIP): 1.084
SCImago Journal Rank (SJR): 0.792
Impact Factor: 2.109
5-Year Impact Factor: 2.096
Ravindra Arya
| James L. Leach
| Liang Guo
Ochuko D. Bakpa
| Markus Reuber
Gerhard Luef
| Erik Tauboll
Ann Jacoby
| Gus A. Baker
Ochuko D. Bakpa
| Markus Reuber
Lorna Myers
| Jace Jones
Teia Kobulashvili
| Julia H?fler
S. Christoffersen
Guy Vingerhoets
Syed Nizamuddin Ahmed
| Zaeem A. Siddiqi
Wolfgang L?scher
| Sebastian Bauer
Martin J. Brodie
| Graeme J. Sills工具类服务
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小儿难治性癫痫的手术治疗及病理结果分析
目的 探讨小儿药物难治性癫痫的外科治疗时机及病理结果与疗效的关系.方法 对71例小儿难治性癫痫进行手术治疗,术后至少随访1年,根据Engel预后分级评估手术效果.结果 术后随访的难治性癫痫患儿中,无癫痫发作(Engel Ⅰ级)的45例(63％),其中全切除32例,次全切除13例,仍有癫痫发作(EngelⅡ～Ⅳ级)的26例(37％),效果与致痫灶切除程度密切相关(P＜0.05).病理结果:局灶性脑皮质发育不良31例,低级别肿瘤18例,瘢痕脑回13例,小脑回畸形6例,结节性硬化3例,其中双重病理9例.无手术死亡和永久性并发症.结论 早期外科手术对小儿难治性癫痫是一种安全有效的治疗方式,其病理类型与手术结果存在一定相关性.
Abstract：
Objective To study the pathological features and the timing and effects of epilepsy surgery in children with intractable epilepsy.Methods The outcomes of 71 pediatric cases that underwent epilepsy surgery in our department were collected.All the patients had at least 1 year of follow-up.The effects of operation were evaluated with Engel class.Results Seizure freedom (Engel Class Ⅰ outcome) was achieved in 45 cases (63％),26 patients (37％) continued to have seizures (Engel Class Ⅱ ～ Ⅳ outcome) (P ＜ 0.05).The major pathological findings in these patients included:focal cortical dysplasia in 31 cases,low grade neoplasm in 18,ulegyria in 13,polymicrogyia malformation in 6,tuberous sclerosis in 3,and dual pathology in 9.There was no death or permanent disability.Conclusions Early surgical intervention was safe and effective for the treatment of intractable epilepsy in children.The relation between the pathological features and surgical effects should be paid attention for further study.
Shan Yongzhi
Zhao Guoguang
Fan Xiaotong
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首都医科大学宣武医院神经外科, 北京,100053
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癫痫患者5572例病因分析
目的 回顾性收集5572例住院癫痫患者的临床资料,分析不同年龄段患者可能的病因并了解病因的构成.方法 收集日至日在我院癫痫中心就诊的住院癫痫病例5572例,根据国际抗癫痫联盟(ILAE) 2005年提出的癫痫诊断标准,由癫痫专科医师诊断为癫痫.依据病史、头部影像学及病理学资料将全部病例分为特发性、症状性、隐源性3类.参考ILAE 2001年癫痫相关疾病的分类,将症状性癫痫病因按脑外伤、围产期损伤、中枢神经系统感染、脑血管病、脑肿瘤、脑皮质发育畸形、神经皮肤综合征和其他病因进行分类.采用非参数分析的多样本秩和检验比较热性惊厥和癫痫家族史在癫痫病因中的作用及诊断价值.结果 5572例患者中,特发性66例,症状性2834例,隐源性2672例,分别占总体的1％,51％和48％.症状性癫痫患者中脑外伤822例、围产期损伤497例、中枢神经系统感染360例、脑肿瘤249例、脑血管病150例、脑皮质发育异常135例、神经皮肤综合征62例,其他559例.脑外伤、围产期损伤、中枢神经系统感染、脑肿瘤和脑血管病为症状性癫痫前5位.隐源性癫痫中海马硬化(或海马异常)者744例.热性惊厥[特发性:15.2％(10/66)、症状性:6.5％(185/2834)、隐源性:9.4％(250/2672);x2=181.393,P=0.000]和癫痫家族史[特发性:83.3％(55/66)、症状性:1.1％(31/2834)、隐源性:0.4％(12/2672);x2=68.354,P=0.000]在不同病因中的比例不同,其差异有统计学意义.热性惊厥史在海马硬化中的比例最高,家族史在症状性癫痫中以神经皮肤综合征比例最高.婴儿、幼儿及儿童、青少年、成年和老年期的首位病因分别是围产期损伤、围产期损伤、脑外伤、脑外伤和脑血管病.结论 对5572例癫痫患者的病因分析提示特发性占1％,症状性占51％,隐源性占48％.脑外伤、围产期损伤、中枢神经系统感染、脑肿瘤及脑血管病是最主要的病因.
Abstract：
Objective To explore the common causes of epilepsy and the etiologic characteristics in different age groups of patients with epilepsy.Methods A retrospective survey was made in 5572 epilepsy patients in Epileptic Center of Guangdong 999 Brain Hospital from January 2003 to December 2009.According to the diagnostic criteria published in 2005 from ILAE,all the diagnoses of 5572 cases were made by epileptic specialists.Based on history,cranial MRI or CT and pathologic data,causes of epilepsy were classified into idiopathic,symptomatic and cryptogenic epilepsy.The cases of symptomatic epilepsy were further arranged into different categories in different age grades,such as head trauma,perinatal injuries,infection in central nervous system, cerebral vascular disease, brain tumor, disorders of cortical development,neurocutaneous syndrome and others.The cases with febrile seizures and family history were collected,and positive ratio of febrile seizures and family history were contrasted in different categories of cases by Kruskal-Wallis test ( nonparametric test ).Results In 5572 cases,66 were idiopathic,2834 symptomatic,2672 cryptogenic,and the ratio of these causes was 1％,51％,48％ respectively.Among 2834 cases of symptomatic epilepsy,822 were head trauma,497 were perinatal injuries,360 were infection in central nervous system,249 were brain tumor,150 were cerebral vascular disease,135 were disorders of cortical development,62 were neurocutaneous syndrome and 559 were others. In brief,head trauma,perinatal injuries,infection in central nervous system,brain tumor and cerebral vascular disease were top 5 causes of symptomatic epilepsy. Hippocampal sclerosis was found in 744 cases in those of eryptogenic epilepsy.The importance of febrile seizures( idiopathic:15.2％ ( 10/66 ),symptomatic:6.5％ ( 185/2834 ),cryptogenic:9.4％ ( 250/2672 ) ; x2 =181.393,P =0.000 ) and family history ( idiopathic:83.3％ ( 55/66 ),symptomatic:1.1％ (31/2834),cryptogenic:0.4％ (12/2672) ; x2 =68.354,P =0.000) was statistically different in different causes of epilepsy.Febrile seizures was the most frequent in cases with hippocampal sclerosis than those with other causes,and family history was the most frequent in neurocutaneous syndrome in symptomatic cases.Perinatal injurics was thc first causc in cases of infancy and childhood,head trauma was the top one in those of juvenile and adulthood,and cerebral vascular disease was the main cause in senile cases. Conclusions In the whole epileptic cases of 5572, 1％ was idiopathic,51％ was symptomatic,and 48％ cryptogenic. The main causes of them were head trauma,perinatal injuries,infection in central nervous system,brain tumor,and cerebral vascular disease.
HU Xiang-shu
DIAO Fang-ming
FEI Ling-xia
CHEN Zhong-jie
ZHANG Pei-qi
CHEN Jun-xi
TAN Qing-hua
WU Xin-yan
ZHOU Jin-hua
SHEN Ding-lie
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广东三九脑科医院癫痫诊疗中心, 广州,510510
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脑卒中后癫痫发作的临床特点和视频脑电图分析
目的：针对脑卒中后癫痫发作的临床特点和视频脑电图表现进行研究，为患者的治疗和预后提供参考依据。方法随机选择2012年12月至2015年12月收治的脑卒中后癫痫发作患者120例作为本次研究的对象，对患者的临床症状、特点，以及视频脑电图特征和表现进行观察分析。结果在本次研究中，脑梗死患者23例，占19.17%；脑出血患者38例，占31.67%；蛛网膜下腔出血患者59例，占49.17%。早发型癫痫发生率为65.00%，迟发型癫痫发生率为35.00%。脑梗死迟发型癫痫发生率（60.87%）明显高于早发型癫痫发生率（39.13%），差异有统计学意义（ P &0.05）。脑出血早发型癫痫发生率（65.79%）明显高于迟发型癫痫发生率（34.21%），差异有统计学意义（ P &0.05）。蛛网膜下腔出血早发型癫痫发生率（77.97%）明显高于迟发型癫痫发生率（22.03%），差异有统计学意义（ P &0.05）。部分性发作的早发型癫痫发生率（7.69%）与明显低于迟发型癫痫发生率（33.33%），差异有统计学意义（ P &0.05）。部分性发作继发全面性发作早发型癫痫发生率（48.72%）明显高于迟发型癫痫发生率（23.81%），差异有统计学意义（ P &0.05）。120例脑卒中后癫痫患者发作期间视频脑电图正常12例，边缘状态脑电图改变10例，视频脑电图异常患者98例。视频脑电图异常以癫痫样放电为主。结论脑卒中后癫痫发作的时间与类型存在相关性，不同类型的脑卒中患者的癫痫发生率不同，且视频脑电图以癫痫样放电为主。
Abstract：
Objective To study the clinical characteristics of epilepsy after stroke and to analyze its video electroencephalogram(eeg), and to provide a reference for the basis of treatment and prognosis evaluation of these patients. Methods A total of 120 patients with seizure after stroke in this hospital during December 2012 to December 2015 were randomly selected in this study,and their symptoms,clinical characteristics and performance in video EEG were analyzed. Results In this study,23 patients with cerebral infarction were accounted for 19. 17% ;38 pa-tients with cerebral hemorrhage were accounted as 31. 67% and 59 patients with subarachnoid hemorrhage were accounted as 49. 17% . The inci-dence of early - onset epilepsy was 65. 00% ,and the incidence of late onset epilepsy was 35. 00% . The incidence of late onset of epilepsy in pa-tients with cerebral infarction(60. 87% )was significantly higher than that of early - onset epilepsy(39. 13% ),and the difference was statistical-ly significant( P & 0. 05). The early - onset epilepsy(65. 79% )in cerebral hemorrhage was obviously higher than that(34. 21% )of late onset epilepsy,and the difference was statistically significant( P & 0. 05). The early - onset epilepsy(77. 97% )in patients with subarachnoid hemor-rhage was obviously higher than that of late onset epilepsy(22. 03% ),and the difference was statistically significant( P & 0. 05). The incidence of partial onset seizure secondary comprehensive attack early - onset seizure(48. 72% )was significantly higher than that of late onset epilepsy (23. 81% ),and the difference was statistically significant( P & 0. 05). The video electroencephalogram(EEG)in 120 patients with epilepsy af-ter onset of stroke was normal in 12 cases,changes at edge state of EEG in 10 cases,and abnormal electroencephalogram(EEG)in 98 patients. The abnormal video electroencephalogram was given priority to sample with epileptic discharge. Conclusion The seizures after stroke were corre-lated with time and types,the incidence of stroke in patients with various types of epilepsy was different,and the manifestations of video electroen-cephalogram(EEG)are mainly presented as epileptic discharge.
FU Ze-juan
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海南省安宁医院神经内科 海南 海口 570206
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