Neurology:脑静脉血栓形成的迟发性发作

2020-08-10 MedSci原创 MedSci原创

在2年的中位随访期间,约有十分之一的CVT患者出现LS。基线颅内出血、急性症状性癫痫发作和接受去骨瓣减压术的患者发生LS的风险增加。

近日,神经病学领域权威杂志Neurology上发表了一篇研究文章,该研究旨在评估脑静脉血栓形成(CVT)后迟发性发作(LS)的发生率、特征、治疗和预测因素,研究人员调查了1127名CVT患者的登记中心,旨在描述了这些特征。

研究人员纳入了来自12家医院为基础的CVT注册管理机构连续就诊的成年患者,排除了有癫痫病史或随访时间少于8天的患者。研究人员将LS定义为诊断为CVT发病7天后出现的癫痫发作,并使用多变量Cox回归来确定LS的预测因子。

研究人员纳入了1127例CVT患者,在2年的中位随访期间(四分位间距[IQR]为1.0-6.3),有123例患者(11%)经历了一次或多次LS(每1000人每年中有30人首次LS,95%CI为25-35)。首次LS的中位时间为5个月(IQR为1-16)。LS的基线预测指标包括急性期癫痫持续状态(风险比[HR]为7.0,95%CI为3.9-12.6)、无癫痫持续状态的急性癫痫发作(HR为4.1,95%CI为2.5-6.5)、脑出血( HR为1.9,95%CI为1.1-3.1)、硬膜下血肿(HR为2.3,95%CI为1.1-4.9)和去骨瓣减压术(HR为4.2,95%CI为2.4-7.3)。尽管有94%的患者在首次LS后接受抗癫痫药物治疗,但仍有85例患者(占LS患者的70%)在随访期间出现了复发性癫痫发作。

由此可见,在2年的中位随访期间,约有十分之一的CVT患者出现LS。基线颅内出血、急性症状性癫痫发作和接受去骨瓣减压术的患者发生LS的风险增加。

原始出处:

Mayte Sánchez van Kammen.et al.Late seizures in cerebral venous thrombosis.Neurology.2020.https://n.neurology.org/content/early/2020/08/05/WNL.0000000000010576

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    2021-05-06 xue8602
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    2020-09-18 yinhl1978
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