酒精相关性癫痫发作患者癫痫复发和癫痫发展的临床特征。

IF 3 Q2 SUBSTANCE ABUSE
Alcohol (Hanover, York County, Pa.) Pub Date : 2024-11-01 Epub Date: 2024-09-27 DOI:10.1111/acer.15449
Min Young Chun, Hyungmi An, Hye Ah Lee, Sungeun Hwang, Seungwon Chung, Na-Young Kim, Hyang Woon Lee
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引用次数: 0

摘要

背景:人们普遍认为戒酒是长期饮酒者急性症状性癫痫发作的诱因。虽然大多数酒精戒断发作发生在戒酒后不久,但长期饮酒可能与癫痫的发展有关,因此必须使用抗癫痫药物(AED)治疗。本研究旨在调查酒精相关性癫痫发作患者的临床特征、癫痫复发和癫痫发展情况,并确定癫痫的预后因素:在梨花女子大学木洞医院进行的一项回顾性分析中,共有 206 名酒精相关性癫痫发作患者接受了检查,其中 15 人因原有癫痫而被排除在外。研究人员调查了人口统计学和临床数据,包括戒酒持续时间、癫痫复发、类型和合并症。采用逻辑回归模型分析癫痫复发和癫痫发展的风险因素。根据接收者操作特征曲线下面积(AUC)评估了最终模型的性能,并使用校准图和一出交叉验证进行了验证:在 191 名酒精相关癫痫发作患者(146 名男性;平均年龄为 48.3 ± 12.1 岁)中,99 名患者(51.8%)癫痫复发,79 名患者(41.4%)发展为癫痫。与癫痫复发相关的因素包括饮酒量、局灶性意识障碍发作、焦虑和头痛。反复发作的次数、半身不遂、癫痫状态、脑电图结果和脑成像结果与癫痫的发展有关。预测模型显示出很强的诊断性能,癫痫复发的AUC为0.833,癫痫发展的AUC为0.939:结论:高酒精消耗量以及特定的临床和诊断特征是酒精相关性癫痫患者癫痫复发和发展的重要预测因素。这些发现强调了早期识别和干预对预防癫痫复发和发病的重要性,并强调了AED治疗对控制这些病症的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical characteristics of seizure recurrence and epilepsy development in patients with alcohol-related seizures.

Background: Alcohol withdrawal is widely recognized as a trigger for acute symptomatic seizures among individuals with chronic alcohol consumption. While most alcohol withdrawal seizures occur shortly after cessation, chronic alcohol consumption can be associated with the development of epilepsy, necessitating anti-epileptic drug (AED) therapy. This study aimed to investigate the clinical characteristics, seizure recurrence, and epilepsy development in patients with alcohol-related seizures and to identify prognostic factors for epilepsy.

Methods: In a retrospective analysis at Ewha Womans University Mokdong Hospital, 206 patients with alcohol-related seizures were examined and 15 were excluded due to preexisting epilepsy. Demographic and clinical data, including alcohol withdrawal duration, seizure recurrence, types, and comorbidities, were investigated. Logistic regression models were used to analyze the risk factors for seizure recurrence and epilepsy development. The performance of the final models was evaluated based on the area under the receiver operating characteristic curve (AUC) and validated using calibration plots and leave-one-out cross-validation.

Results: Of the 191 patients (146 males; mean age 48.3 ± 12.1 years) with alcohol-related seizures, 99 patients (51.8%) experienced seizure recurrence and 79 patients (41.4%) developed epilepsy. Factors associated with seizure recurrence included alcohol consumption levels, occurrence of focal impaired awareness seizure, anxiety, and headache. The number of recurrent seizures, semiology, status epilepticus, electroencephalogram findings, and brain imaging findings was associated with epilepsy development. The predictive models showed strong diagnostic performance, with AUCs of 0.833 for seizure recurrence and 0.939 for epilepsy development.

Conclusion: High alcohol consumption and specific clinical and diagnostic features are significant predictors of seizure recurrence and the development of epilepsy among patients with alcohol-related seizures. These findings underscore the importance of early identification and intervention to prevent seizure recurrence and the onset of epilepsy, emphasizing the importance of AED treatment in managing these conditions.

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