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老年非惊厥性癫(疒间)持续状态5例临床分析
曲立新,程凯,宋军1,李秀峰1,时兴华1,张之营1*,徐贵霞2*
0
(1. 德州市人民医院神经内科, 德州 253014;
2. 第二军医大学长海医院临床实验中心, 上海 200433
共同第一作者
*通信作者)
摘要:
目的:由于非惊厥性癫痫持续状态(NCSE)病因复杂,临床表现多样,容易被误诊,而老年患者基础疾病多,使其诊断治疗更为困难。本研究主要是探讨老年NCSE的临床表现、治疗及视频脑电图的诊断价值。方法:对我院诊治过的5例老年NCSE患者的临床资料及脑电图资料进行回顾性分析。结果:5例患者发作时均表现为行为异常。3例患者既往有脑梗死后癫痫病史,1例患者因NCSE发作来诊,诊断为颅内感染。1例既往癫痫病史。5例病人发作时视频脑电图均表现为持续性痫样放电。发作时5例患者静脉滴注地西泮效果良好。5例患者根据癫痫发作形式予不同抗癫痫药物,控制尚可。结论:老年NCSE患者精神行为异常仍为其主要表现,长程视频脑电图监测为疾病的诊断提供可靠依据,合理使用抗癫痫药物疗效显著。地西泮静脉缓慢滴注对老年NCSE患者同样适用。
关键词:  非惊厥性癫(疒间) 持续状态  老年人  诊断  治疗  脑电图
DOI:10.3724/SP.J.1008.2015.01039
投稿时间:2015-01-18修订日期:2015-03-12
基金项目:
Clinical analysis of five elderly patients with non-convulsive status epilepticus
QU Li-xin,CHENG Kai,SONG Jun1,LI Xiu-feng1,SHI Xing-hua1,ZHANG Zhi-ying1*,XU Gui-xia2*
(1. Department of Neurology, Dezhou People's Hospital, Dezhou 253014, Shandong, China;
2. Clinical Laboratory Center, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
Co-first authors
* Corresponding author)
Abstract:
Objective: The non-convulsive status epilepticus (NCSE) is easy misdiagnosed due to its complex etiology, clinical manifestations. It is more difficult to diagnose and treat for elderly patients with multiple basic diseases. The purpose of this study is to investigate the clinical characteristics of elderly patients with NCSE, therapy, diagnosis, and the value of long-range video electroencephalography (LV-EEG). Methods: The clinical and electroencephalography (EEG) data of the five elderly patients with NCSE in my hospital were analyzed retrospectively.Results: Five patients showed episodes of abnormal behavior during seizure (5/5). There were 3 patients with previous history of epilepsy after cerebral infarction (3/5), 1 patient diagnosed intracranial infection because of NCSE episodes to consultation (1/5), and 1 case with previous history of epilepsy (1/5). The V-EEG of the 5 patients showed persistent epileptic form discharges during seizure. Intravenous diazepam had good effect to the 5 patients during seizure. Seizure of the 5 cases was controlled acceptably with different antiepileptic drugs according to different epilepsy forms.Conclusions: The abnormal mind and behavior is still main performance in elderly patients with NCSE. The LV-EEG provides reliable foundation for diagnosis of the disease. The rational use of antiepileptic drugs is effective. Intravenous diazepam slow for elderly patients with NCSE is applied as well.
Key words:  non-convulsive status epilepticus  aged  diagnosis  therapy  electroencephalography