Clinical Study Of 65 Cases Of Hematological Diseases With Epilepsy

Orbjective The purpose of this study is to summarize the clinical characteristics of epileptic seizure patients with hematological diseases in oder to improve our understanding of these conditions.Methods Clinical and imaging data of patients diagnosed with hematological diseases and epilepsy from May 2016 to October 2022 were retrospectively analyzed.Results A total of 9816 patients with hematological disorders were admitted during the study period,and 65 patients had seizures associated with hematological disorders.The median age was 38 years and the ratio of males to females was 1 to 1.There were 28 cases of aplastic anemia,13 cases of leukemia,7 cases of myelodysplastic syndrome,8 cases of lymphoma,3 cases of multiple myeloma,and 6 cases of thrombocytopenia.The incidence of epilepsy in different hematological diseases was:aplastic anemia 0.86%,leukemia 1.24%,myelodysplastic syndrome 0.58%,lymphoma 0.66%,multiple myeloma 1.18%,and thrombocyopenia 0.42%.Specific research results are as follows:1.General tonic-clonic seizures were the main seizure type(59 cases).Of the six hematological disorders,only aplastic anemia showed statistically significant differences between seizure type groups(Fisher’s exact test P<0.05).In this study,the duration of seizures ranged from 1min to 20min,among which 22 patients had persistent seizures,20 had general seizures,1 had focal seizures,and 1 had non-convulsive seizures.2.The time between the occurrence of epilepsy and the diagnosis time of blood system diseases and the time of the last treatment are in different blood system diseases,the shortest time is about 1 week,the longest time is about 60 months.3.In this study,the completion rate of cranial imaging examination was 78.46%,and the completion rate of cerebrospinal fluid examination was 10.77%.Through the above two examinations,it was found that the main causes of epilepsy were cerebral hemorrhage,reversible posterior encephalopathy syndrome,intracranial venous sinus thrombosis,intracranial infection,intracranial space occupying and metabolic encephalopathy.Most patients combined with cerebral hemorrhage,the bleeding site is usually unilateral frontal lobe or occipital lobe;Reversible posterior encephalopathy syndrome imaging findings were also not limited to the posterior cranial region.Maltophilia and cryptococcus were found in the culture of cerebrospinal fluid,but the biochemical and routine tests showed no obvious specificity.There were statistical differences in the incidence of cerebral hemorrhage,intracranial space occupation and intracranial venous sinus thrombosis among different bood system disease groups(Fisher’s exact test P<0.05).4.The completion rate of electroencephalogram in patients with hematological diseases and epilepsy was 53.85%.Among the 6 hematological diseases,only aplastic anemia had a statistical difference in the presence or absence of epileptoid dicharges in interseizure EEG(Fisher’s exact test P<0.05).5.Twenty-nine patients with hematological diseases received Debarking injection combined with midazolam injection during acute seizures.Levetiracetam tablts alone were used in 23 patients with symptomatic epilepsy.6.In this study,53 patients(81.54%)survived and 12 patients(18.46%)died after discharge were observed.There were no significant differences among survival groups in gender,age,duration of seizures,presence or absence of intravenous or oral chemotherapy drugs,bone marrow transplantation,intravaginal injection,or cause of seizures(Fisher’s exact test P>0.05).In this study,the characteristics of epileptic seizure were observed,including 21 cases(32.31%)of single epileptic seizure and 44 cases(67.69%)of multiple epileptic seizure.Bone marrow transplantation,intravenous or oral chemotherapeutic drugs were statistically different among different seizure frequency groups(Fisher’s exact test P<0.05),and the correlation between them and seizure frequency was r=0.401(P<0.05)and r=0.257(P<0.05),respectively.In this study,a total of 22 Status epilepticus patients(33.85%)were enrolled,and there was a statistical difference between the groups with or without epileptic status in whether bone marrow transplantation was performed(Fisher’s exact test P<0.05).The correlation between bone marrow transplantation ad epileptic status was r=0.337(Fisher’s exact test P<0.05).Conclusion Epileptic seizures are common in the neurological complications of hematological diseases,especially malignant hematological diseases,and increase the difficulty of treatment in patients with hematological diseases and affect the prognosis.In the process of diagnosis and treatment of blood system diseases,especially in the early stage,it should be emphasized to prevent,identify and timely deal with the factors that cause seizures in the process of diagnosis and treatment.