The Study Of Clinical Prognosis Of The First Acute Symptomatic Seizure

Objective:Analyze the clinical character and prognosis of acute symptomatic seizu res and evaluate risk factors which have influence on their prognosis to provide r eference for clinical intervention.Methods:Make telephone follow-up for one month,three months,six months and one year to 115 patients who were hospitalized in the department of neurology of Shengjing hospital affiliated to China medical university manifesting acute symptomatic seizures.SPSS 24 is used to compare differences between recurrence group and nonrecurrence group by t-test,chi-square tests.Risk factors are analyzed with multivariate analysis according to the Cox regression model.Make analysis on the actuarial probabilities by the Kaplan-Meier method.Results:Among 115 patients diagnosed with acute symptomatic seizures,74 are male(64.3%),41(35.7%)are female,77 patients’ seizure type is generalized tonic-clonic seizure(67.0%),10 patients(8.7%)manifested status epilepticus and 40(34.8%)received AEDs therapy.EEG results of some patients who have had EEG examination suggest epileptiform discharges(15.9%).The main cause is acute cerebral infarction and central nervous system infection.25 patients have seizure recurrence in the follow-up period and 9 patients lose follow-up.68 patients have one-year follow-up.After analysing their data,a pattern of recurrence is found,with the probability of recurrence reaching 7.4% by 1 month,16.2%by 3 months and 36.8% by 1 year.Partial seizure(P=0.008),status epilepticus(P=0.016)and cortical lesions(P=0.007)are the independent risk factors for seizure recurrence.Discrepancy in the type of partial seizure between recurrence group and no recurrence group is significant(P=0.019).Differences of age(P=0.322),gender(P=0.614),previous history of nervous system(P=0.591),abnormal CT results(P=0.589),abnormal MR results(P=0.764),short-term AEDs application(P=0.651)and the type of generalized tonic-clonic seizure(P=0.356)between two groups have no significance.A variety of nervous system diseases including acute cerebral infarction,acute intracerebral hemorrhage,central nervous system infection,central venous thrombosis,autoimmune encephalitis and reversible posterior leukoencephalopathy syndrome can cause acutesymptomatic seizures.Differences in these causes between two groups have no significance.Conclusion:Patients who manisfested first acute symptomatic seizures are mainly male and the major seizure style is generalized tonic-clonic seizure.The main cause is acute cerebral infarction and central nervous system infection.The cumulative probability of recurrence after first acute symptomatic seizures rises gradually as time goes on.Partial seizure,status epilepticus and cortical lesions are the independent risk factors for seizure recurrence.