比较重症监护病房中孤立性癫痫发作和癫痫持续状态患者:一项观察性队列研究[j] - Neurology - JO - Neurology - DO . 10.1212/WNL.0000000000206838首页Sp - 10.1212/ wnl.0000000000206838盟——安娜年代瓦格纳AU - Sira M鲍曼盟Saskia Semmlack AU -安雅我弗雷盟Stephan Ruegg AU -萨比娜·亨泽尔盟Stephan Marsch AU -苏特拉乌尔Y1 - 2023/03/06 UR - //www.ez-admanager.com/content/early/2023/03/06/WNL.000000000020首页6838.abstract N2 -目的:评估的频率癫痫持续状态(SE)抓住成人危重患者并确定临床孤立的癫痫患者和患者之间的差异SE在重症监护室(ICU)。方法:从2015-2020年，通过筛选所有数字医疗、ICU和EEG记录，确定瑞士三级保健中心ICU中由重症医师和/或咨询神经科医师报告的所有连续的孤立性癫痫发作或SE成人患者。排除18岁及脑电图无癫痫发作的缺氧缺血性脑病所致肌阵挛患者。孤立性癫痫发作和SE的频率以及与SE相关的癫痫发作时的临床特征是主要结局。进行单变量和多变量逻辑回归以确定与SE出现的关联。结果:404例癫痫发作患者中，51%为SE。与孤立性癫痫发作患者相比，SE患者的Charlson共病指数(CCI)中位数较低(3比5,p=0.039)，致死性病因较少(43.6%比80.5%，p= 0.001)，格拉斯哥昏迷评分中位数较高(7比5,p= 0.001)，发热频率较高(27.5%比7.5%，p=0.039)，中位数ICU和住院时间较短(ICU: 4比5天，p=0.039;住院时间:13天对15天，p=0.045)，恢复到病前功能的频率更高(36.8%对17%，p= 0.001)。多变量分析显示，SE的优势比(OR)随着CCI (OR=0.91, 95%可信区间[CI] 0.83-0.99)、致死病因(OR=0.15, 95%CI 0.08-0.29)和癫痫(OR=0.32, 95%CI 0.16-0.63)的增加而降低。在排除以癫痫作为ICU入院原因的患者后，全身炎症与SE存在额外的相关性(ORfor CRP=1.01, 95%CI 1.00-1.01; ORfor fever=7.35, 95%CI). While fatal etiologies and increasing CCI remained associated with low odds for SE after excluding anesthetized patients and hypoxic-ischemic encephalopathy, inflammation remained associated in all subgroups except patients with epilepsy.Conclusions: Among all ICU patients with seizures, SE emerged frequently and seen in every second patient. Besides the unexpected low odds for SE with higher CCI, fatal etiology, and epilepsy, the association of inflammation with SE in the critically ill without epilepsy represents a potential treatment target and deserves further attention. ER -