성인 입원환자에서 간질증첩증의 원인 및 임상결과
Status Epilepticus in Adult Hospitalizde Patients: Cause and Clinical Outcome
최휘철, 송홍기, 이병철,
소속 상세정보
최휘철 ( Choi Hui-Chul )
한림대학교 의과대학 신경과학교실
송홍기 ( Song Hong-Ki )
한림대학교 의과대학 신경과학교실
이병철 ( Lee Byung-Chul )
한림대학교 의과대학 신경과학교실
KMID : 0877219990030020174
Abstract
Background and purpose: Status epilepticus (SE) is one of the major neurological emergency that requires immediate treatment to avoid significant morbidity and mortality. Thus, understanding the cause, features and prognosis of SE is important for the evaluation and treatment of this condition. We retrospectively reviewed the possible cause and clinical outcome of adult patients treated for SE at the Hallym Univrsity Hospital from 1994 to 1998.
Methods: For the identification of patients, we searched the data bank for patients meetinf criteria of SE who were 18 year or older, and their medical records were reviewed. We also investigated the relationships between cause, response to anticonvulsant therapy and short-term clinical outcome.
Results: The selected 127 patients wer 84 males and 43 females, aged 18 to 85 yeats (meen age: 49.5 years). The possible etiologies of SE were withdrawal of AED (n=27, 21.3%), anoxia (n=22, 17.3%), CNS infection (n=20, 15.7%), stroke (n=16, 12.6%), alcohol-related (n=15, 11.8%), metabolic (n=8, 6.3%), unknown (n=7, 5.5%), drug inroxicatio (n=5, 3.9%), trauma (n=4, 3.2%) and cerebral tumor (n=3, 2.4%). in 77 patients (n=77, 60.6%), SE was successfully aborted with first-line therapy, which usually included diazepam with or without phenytoin. The food responders to AEDs occurred in patients with AED withdrawal, alcohol-related, stroke, unknown, and trauma, The poor response related to anoxia, drug intoxication and CNS infection. Seventy nine patients (62.2%) had food outcome, but nineteen patients (14.9) were died. Anoxia, drug intoxication, CNS infection and metabolic abnormalities were associated with particularly poor outcome compared with other etiologies.
Conclusion: This study indicates that the etiology of SE may help predict both the intial response to drug therapy and short-term clinical outcome.
키워드
간질중첩증;원인;임상결과
원문 및 링크아웃 정보
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