간질중첩 상태의 임상분석

A Clinical Analysis of Status Epilepticus

For more understanding of status epilepticus: which is an emergent condition with high mortality and requires immediate treatment, we reviewed and analyzed clinical records of 94 patients with status epilepticus, who had been hospitalized from 1974 to 1983 in the Seoul Red Cross Hospital. The results were summarized as follows; 1. The rate of status epilepticus was 8.6% for the 1098 inpatients with seizure disorder. Also, 50% of these were below age 20. 2. Regarding types of seizures, generalized tonic & clonic seizure was the most common type and accounted for 45.7% of the total patients with statu s epilepticus. 3. Among the total number of patients diagnosed with status epilepticus, symptomatic status epilepticus comprised 57.4% . The primary causes included: (1) Infectiousdisease (29.696) (2) Head tra u m a (22.2% ) (3)’ Cerebro-vascular disease (14.8% )，and (4) other (33.4% ). 4. As to precipitating factors, irregularity or discontinuation of anticonvulsant medication was noted in 31.6% , fever was evident in 29.8% and psychic factors was prominent in 10.5%. 5. Regarding the axillary temperatures, morethan half (61.6%) of the 78 patients with status epilepticus without underlying in fectious disease rose above 37°C. 6. The leukocyte count of the peripheral blood show ed leukocytosis in 60. %% of the 74 patients with status epilepticus with out underlying infectious disease. Also, differential counts of leukocyte were performed in 70 patients who had no underlying infectious disease. As a result, neutrophilia appeared in 6096 and lymphocytosis appeared in 5 .1%. 7. In the measurem ent of serum electrolytes (Na and Ca), hyponatrem ia appeared in 44.4% , and hypocalcem ia appeared in 9.5% . 8. In C.S.F. findings, the pressure was increased in 2 3 .596 of the 34 patients with out anyunderlying infectious disease, cerebrovascular disease, brain tumor, metabolic disorder. Also, pleocytosis was noted in 14.7%. 9. As to E.E.G. classification, moderate abnorm-ality was the most common abnormal type (33.3% ). The next included marked abnormality (25.4% ). Normal E.E.G . findings comprised only 9.5% . The abnormal wave patterns included generalized slow waves (30.4% ), suppression of background rhythms (26.9% ), focal slow waves (24.7% ), and etc. 10. Total mortality was 13.8% , and 76.9% of these died with in a week. The mortality of symptomatic status epilepticus (53.8% ) was higher than idiopathic status epilepticus. The causes of death was established in 38.5% of the mortality.