Influencing factors of postencephalitic epilepsy in children with viral encephalitis at acute symptomatic seizure

Q4 Medicine

中华实用儿科临床杂志 Pub Date : 2020-04-08 DOI:10.3760/CMA.J.CN101070-20190814-00745

L. Guan, Peng Liu, Hai-ying Li, Wei Ma, L. Xie, P. Jin, X. Fang, Huaili Wang

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引用次数: 1

Abstract

Objective To discuss the incidence rate and influencing factors of postencephalitic epilepsy (PE) in children with viral encephalitis at acute symptomatic seizure(ASS). Methods The data of 132 children with ASS in the First Affiliated Hospital of Zhengzhou University from September 2013 to July 2018 were retrospectively analyzed, and the patients were divided into PE group (62 cases) and non-PE group (70 cases) according to whether they had PE at final follow-up.The risk factors of PE in children with ASS were analyzed using the multivariate Logistic regre-ssion methods. Results The incidence of PE in children with ASS was 46.97% (62/132 cases). There were statistically significant differences in terms of psychological and behavioral abnormalities[19.4%(12/62 cases) vs.2.9%(2/70 cases)], repetitive seizures (more than 5 seizures) [67.7%(42/62 cases) vs.17.1%(12/70 cases)], status epilepticus (SE) [30.6%(19/62 cases) vs.11.4%(8/70 cases)], generalized seizures [72.6%(45/62 cases) vs.88.6%(62/70 cases)], endotracheal intubation [21.0%(13/62 cases) vs.2.9%(2/70 cases)], the duration of fever [5.5(3.0, 11.0) d vs.3.0(2.0, 6.0) d], the duration in the intensive care unit (ICU) [13(5, 21) d vs.6(3, 8) d], electroencephalography epileptiform discharges [49.1%(27/55 cases) vs.6.8%(4/59 cases)], presence of subcortical involvement on neuroimaging [37.3%(22/55 cases) vs.20.3%(14/59 cases)] in children with ASS between the PE group and the non-PE group(all P<0.05). The multivariate Logistic regression analysis showed that repetitive seizures (more than 5 seizures) (OR=5.256, 95%CI: 1.538-17.961, P=0.008), SE(OR=6.003, 95%CI: 1.411-25.539, P=0.015), electroencephalography epileptiform discharges (OR=36.693, 95%CI: 7.031-191.485, P<0.01) and the duration in ICU (OR=1.170, 95%CI: 1.058-1.298, P=0.002) were the risk factors for PE in children with ASS. Conclusions The incidence rate of PE in children with ASS is high.Children with ASS are more likely to develop into PE if they have repetitive seizures (more than 5 seizures), SE, electroencephalography epileptiform discharges, and the longer duration in ICU. Key words: Child; Viral encephalitis; Seizures; Postencephalitic epilepsy; Risk factor

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病毒性脑炎患儿急性症状性发作并发脑后癫痫的影响因素

目的探讨病毒性脑炎患儿急性症状性发作（ASS）并发脑后癫痫（PE）的发病率及影响因素。方法回顾性分析郑州大学第一附属医院2013年9月至2018年7月收治的132例ASS患儿的临床资料，根据最终随访时是否有PE，将患者分为PE组（62例）和非PE组（70例）。结果ASS患儿PE发生率为46.97%（62/132例）。在心理和行为异常[19.4%（12/62例）vs.2.9%（2/70例）]、重复性癫痫发作（5次以上）[67.7%（42/62例）vs7.1%（12/70例））、癫痫持续状态（SE）[30.6%（19/62例）vs 11.4%（8/70例）、全身性癫痫发作[7.26%（45/62例）对8.86%（62/70例），气管插管[21.0%（13/62例）vs.2.9%（2/70例）]，发烧持续时间[5.5（3.0，11.0）d vs.3.0（2.0，6.0）d]，在重症监护室（ICU）的持续时间[13（5，21）d vs.6（3，8）d]、脑电图癫痫样放电[49.1%（27/55例）vs.6.8%（4/59例）]，在患有ASS的儿童中，PE组和非PE组之间存在皮质下受累的神经成像[37.3%（22/55例）vs.20.3%（14/59例）]（均P<0.05）。多变量Logistic回归分析显示，重复性癫痫发作（5次以上）（OR=5.256，95%CI:1.538-17.961，P=0.008）、SE（OR=6.003，95%CI:1.411-25.539，P=0.015），脑电图痫样放电（OR=36.693，95%CI:7031-191.485，P<0.01）和ICU持续时间（OR=1.170，95%CI:1.058-1.298，P=0.002）是ASS患儿PE的危险因素。如果患有ASS的儿童有重复性癫痫发作（超过5次癫痫发作）、SE、脑电图癫痫样放电以及在ICU的持续时间较长，他们更有可能发展为PE。关键词：儿童；病毒性脑炎；扣押；脑后癫痫；风险因素

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来源期刊

中华实用儿科临床杂志 Medicine-Pediatrics, Perinatology and Child Health

CiteScore

0.60

自引率

0.00%

发文量

14243

期刊介绍： Chinese Journal of Applied Clinical Pediatrics ( semi-monthly ) is a core journal of paediatrics under the supervision of China Association for Science and Technology, sponsored by Chinese Medical Association and undertaken by Xinxiang Medical College. Founded in 1986, it is openly circulated both at home and abroad. The journal has several columns, such as Expert Forum, Experimental Research and Paediatric Surgery, which are mainly for paediatric medical workers and medical researchers in hospitals. Its purpose is to reflect the new theories and technologies in paediatric medicine and scientific research at home and abroad, and to promote academic exchanges. Chinese Journal of Applied Clinical Pediatrics is a source journal of China Science Citation Database (CSCD), a core journal of Peking University, a source journal of Chinese science and technology paper statistics (China Science and Technology Core Journals), a core academic journal of RCCSE, a high-quality scientific and technical journal of China, a high-quality scientific and technical journal of China Association for Science and Technology, and a high-quality scientific and technical journal of China Biomedical Science and Technology Association. We have been published in China Biomedical Literature Database (SinoMed), China Knowledge Network, Wanfang Data Knowledge Service Platform, China Academic Journal Abstracts, Scopus Database, Chemical Abstracts (USA), Japan Science and Technology Agency (JSTA) Database, Copernicus Abstracts (Poland), Abstracts of the Centre for Agricultural and Biological Sciences (CABS) of the United Kingdom, Cambridge Scientific Abstracts ProQuest Database, WHO Medical Journal of the Western Pacific Region (WMPR), and WHO Medical Journal of the Western Pacific Region (WMPR) of the United States. We have been included in dozens of authoritative databases at home and abroad, such as WHO Western Pacific Region Index of Medicine (WPRIM), Ullrich's Guide to Periodicals, and so on.