Neurology:老年卒中幸存者新发癫痫和难治性癫痫的风险

2019-07-11 xing.T MedSci原创

由此可见,老年卒中幸存者发生癫痫和药物难治性癫痫的可能性较小。据报道,新发癫痫的老年卒中幸存者中86.6%的死亡原因归因于卒中或癫痫以外的原因。

近日,神经病学领域权威取杂志Neurology上发表了一篇研究文章,研究人员旨在明确老年卒中幸存者中与新发癫痫和难治性癫痫相关的因素,并评估发生癫痫的参与者的诊断护理和死亡率情况。

研究人员使用相关的行政医疗保健数据库进行了一项基于人群的回顾性队列研究。安大略卒中登记处用于确定在2003年4月1日至2009年3月31日期间在加拿大安大略省指定卒中中心住院治疗的67岁及以上患者,并且之前没有癫痫。多变量细灰色风险模型用于评估癫痫和难治性癫痫的危险因素,从而确定死亡的竞争风险。

在19138名因卒中住院的老年人中,210名(1.1%)患有癫痫,27名(12.9%)患有抗癫痫药物。在癫痫诊断的1年内,24例(11.4%)患者接受脑电图检查,19例(9.0%)接受MRI检查。在多变量分析中,年龄较小和溶栓治疗会明显增加癫痫风险。较轻的卒中严重程度和抗凝药物治疗也显著增加癫痫风险;然而,随着时间的推移,这些效应有所减弱,年龄较小和女性是难治性癫痫的唯一危险因素。在癫痫诊断后的5年内,97名(46.2%)参与者死于任何原因。

由此可见,老年卒中幸存者发生癫痫和药物难治性癫痫的可能性较小。据报道,新发癫痫的老年卒中幸存者中86.6%的死亡原因归因于卒中或癫痫以外的原因。 

原始出处:

Jorge G. Burneo, et al.The risk of new-onset epilepsy and refractory epilepsy in older adult stroke survivors.Neurology.2019.https://doi.org/10.1212/WNL.0000000000007895

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    2019-09-08 yinhl1978
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    2019-07-13 freve
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    2019-07-11 健健

    卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!

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