간질 중첩증에 관한 임상적 연구

A Clinical Study of Status Epilepticus

Status epilepticus has been recognized as the most serious emergency states among the epileptic conditions. In this study, it was attempted to reveal the characteristic clinical aspects of the status epilepticus in their age and sex distribution, socioeconomic status, causes and precipitating factors, aura, types of seizure, clinical aspects of seizure,therapeutic significance of anticonvulsant, and prognosis. Nineteen cases of status epilepticus who were admitted to Dept, of Neuropsychiatry, KangNam Sacred Heart Hospital and Han Gang Sacred Heart Hospital, Hallym College, from January 1980 to December, 1981. The results were as follows； 1. In the sex distribution of status epilepticus, there was no significant difference in both sex. In the age distribution majority of them (57.8%) were distributed to the 3rd decade, and their mean age was 25.5. 2. As to the socio-economic status, majority of them (68.4%) were distributed to the lower level. 3. Idiopathic status occupied 57.8%, while symptomatic status occupied 41.1%, The most common precipitating factor was found to be irregular anticonvulsant medication (26.3% ). 4. The rate of the epileptic status patients who had aura before seizure were 36.8% of all patients, and the most common aura was headache. 5. Abnormal EEG were found from 73.3% of the patients who took EEG, and the most freqent location of abnormal EEG was frontal region (45.4%). Abnormal CT findings of the brain were found from 41.1% of patients who took CT scan of the brain. 6. As to the types of seizure in status epilepticus, majority of them (84.2%) had generalized seilzure, minority of them (15.896) partial seizure. The most common type was tonic-clonic (73. 696). 7. As to past history of epilepsy, 26. 3% of status epilepticus had no history of preious seizure in their past life. 8. The majority of status epilepticus occurred in nocturnal time, especially during the sleep tim and in winter and summur. Seasonally. 9. The most frequent number of seizures in status epilepticus was 6-10. The most common interval between the onset of status and the beginning of treatment was 1-2 hours (31.6%), and mean interval in all cases was 8.9 hours. Thus the more this interval was prolonged, the more time for seizure control was needed and recovery of consciousness was delayed The most common recovery time of consciousness after treatment was 3-5 hours. 10. In treatment of ststatus epilepticus, intrave-nous diazepam were effective for 63.2% of patie- nts, and intravenous thiopental sodium was effe-ctive in serious status epilepticus. 11. Prognosis of 36.8% in all patients was poor, but immediate therapeutic management was esse-ntial for good prognosis.