滴疾重叠症의 臨床的 考察

A Clinical Study of Status Epilepticus

An attempt was made to study the problems and preventive measures on the therapeutic managem ent of the status epilepticus, which is one of the em ergency diseases in the neuropsychiatry. The author reviewed the clinical records of 51 inpatients with status epilepticus who have been hospitalized in the neuropsychiatric ward of Kyung-Hee University Hospital during a period from Oct. 1971 to Aug. 1981. T he results were summarized as follows； 1. The rate of status epilepticus out o f the total epileptic inpatients o f 240 in the period was 21.3 %. 75% of them were in the age above 21. Male to female ratio was 29 ： 22. More than half of the patients belonged to the lower socioeconomic class. 2. Age of onset in the initial status epileptic patients was between 11 and 20, whereas that in the intercurrent status epileptic patients was between 21 and 30. The interval between first seizure and first intercurrent status epilepticus was mostly less than 10 years and that in more than half of them was less than 1 year. 3. More than half of those with intercurrent status epilepticus had been managed with the herb practice, folk therapy, and superstitious measures, and the remaining patients have been treated with anticonvulsant medication, though in general, on irregular basis. 4. It was found that a majority of the patients had precipitating factors. The more frequent prec ipitating factors were irregular medication, high fever, alcohol drinking, and hypoglycem ia, in that order. 5. 94% of them showed grand mal type seizure. 35.3% was sym ptom atic type and 64.7%, idiopathic. Most of them experienced at least 4 times of seizure attacks, and about half of them, more than 10 times. The duration o f unconsciousness was mostly less than 24 hours. 55% of the seizures occured during sleep, especially early in the morning, and 41% of them occured in winter. The overall mortality rate was A%t and the cause of death was respiratory failure. 6. 81% o f the patients showed EEG abnormalities. In 54% of the patients were found focal sites, and most of the focal sites were in the fronto-temporal areas. 7. In the therapeutic management of status epilepticus, intensive follow-up measures including regular administration of anticonvulsant drugs and prevention of possible precipitating factors are thought to be important.