脑膨出患者癫痫发作的预测因素;在三级医院工作了11年。

IF 0.9 4区 医学 Q4 CLINICAL NEUROLOGY
Pediatric Neurosurgery Pub Date : 2023-01-01 Epub Date: 2023-09-26 DOI:10.1159/000534140
Amirhosein Nejat, Samuel Berchi Kankam, Vahid Heidari, Keyvan Tayebi Meybodi, Zohreh Habibi, Sajedeh Karami, Farideh Nejat
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引用次数: 0

摘要

引言:研究并确定与脑膨出(EC)患者癫痫发作发生率相关的预测因素。方法:对2010年至2021年间在德黑兰一家三级医疗中心接受EC治疗的患者进行回顾性分析。评估了包括出现时的年龄、性别、位置、EC大小和内容物、脑室肥大、脑积水、相关异常和神经发育迟缓(NDD)在内的数据的预后价值。此外,还进行了详细的单变量和多变量统计分析,以确定独立预测因素与癫痫发作发生率之间的相关性。结果:共发现102例EC。71个内皮细胞(69.6%)为后部内皮细胞,31个(30.4%)为前部内皮细胞。在43例(42.2%)EC中发现了神经组织。33名患者(32.4%)患有脑室肥大,其中90.9%的患者因进行性或症状性脑积水接受了分流治疗。癫痫发作26例(25.5%)。在单变量分析中,其他异常、术后感染和NDD的存在与癫痫发作有关(p<0.05)。当在单变量研究中将异常分为颅内组和颅外组时,没有异常与癫痫发作的统计学显著增加有关(p值分别为0.09和0.61)。尽管根据多变量分析,只有其他相关异常与癫痫发作之间的相关性在统计学上接近显著(OR:2.0,95%CI;0.95-4.2,p=0.049)。当将异常分为颅内组和颅外组时,没有任何异常与癫痫发生的统计学显著增加相关(p值分别为0.09和0.61)。与其他无NDD的患者相比,患有NDD和术后感染的儿童发生癫痫发作的风险分别高3.04和1.3倍(95%CI;0.9-4.2,p=0.46)。结论:我们发现EC患者的癫痫发作风险为25.5%。本研究没有发现任何显著的EC患者癫痫发作的预测因素。然而,患有术后感染(包括败血症、伤口感染和NDD)的儿童患者需要更多的考虑来降低癫痫发作的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Predictors of Seizures in Patients with Encephalocele: An 11-Year Experience from a Tertiary Hospital.

Introduction: The aim of the study was to investigate and identify the predictors associated with the incidence of seizures in patients with encephalocele (EC).

Methods: A retrospective analysis was undertaken of patients treated for EC at a tertiary medical center in Tehran between 2010 and 2021. Data including age at presentation, gender, location, size, and content of EC, ventriculomegaly, hydrocephalus, associated anomalies, and neurodevelopmental delay (NDD) were evaluated for their prognostic value. In addition, univariate and multivariate analyses were performed to identify the correlation between independent predictors and seizure incidence.

Results: One hundred and two cases of EC were identified. Seventy-one ECs (69.6%) were posterior ECs, while 31 (30.4%) were anterior. Neural tissue was found in 43 (42.2%) of the ECs. Thirty-three patients (32.4%) had ventriculomegaly, of which 90.9% underwent shunt placement for progressive or symptomatic hydrocephalus. Seizure was found in 26 (25.5%) patients. On univariate analysis, presence of other anomalies, postoperative infections, and NDD were associated with seizures (p < 0.05). When the anomalies were categorized into intracranial and extracranial groups in univariate analysis, none was associated with statistically significant increase in seizure (p values of 0.09 and 0.61, respectively). Although according to multivariate analysis, only the association between other associated anomalies and seizure was near significant (OR: 2.0, 95% CI: 0.95-4.2, p = 0.049). Children with NDD and postoperative infection were, respectively, 3.04 and 1.3 times more at risk to experience seizures compared to other patients.

Conclusion: We found a rate of 25.5% risk of seizure in patients with EC. This study could not find any significant predictors of seizure in children with EC. However, pediatric patients with postoperative infections including sepsis, wound infection, and NDD require more consideration to reduce the risk of seizure.

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来源期刊
Pediatric Neurosurgery
Pediatric Neurosurgery 医学-临床神经学
CiteScore
1.30
自引率
0.00%
发文量
45
审稿时长
>12 weeks
期刊介绍: Articles in ''Pediatric Neurosurgery'' strives to publish new information and observations in pediatric neurosurgery and the allied fields of neurology, neuroradiology and neuropathology as they relate to the etiology of neurologic diseases and the operative care of affected patients. In addition to experimental and clinical studies, the journal presents critical reviews which provide the reader with an update on selected topics as well as case histories and reports on advances in methodology and technique. This thought-provoking focus encourages dissemination of information from neurosurgeons and neuroscientists around the world that will be of interest to clinicians and researchers concerned with pediatric, congenital, and developmental diseases of the nervous system.
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