Etiological Analysis Again Of Adulthood Starting With Epilepsy : A Hospital-based Study

In accordance with the characteristics of etiology, epilepsy can be classified as idiopathic epilepsy, secondary epilepsy and cryptgenic epilepsy, and most of the epilepsy types is secondary epilepsy, and the causes are diverse. Objective:Through the analysis of the cause of adults with epilepsy in different constituent ratio, nearly 50 years of adult epilepsy the change of the spectrum are discussed; Comparing general hospital and the cause of epilepsy center constituent ratio, explore a comprehensive hospital in epilepsy due to the lack of diagnosis. It will provide useful experience and ideas for adult epilepsy for studies. Methods:Collected 1606 outpatients and inpatients with epilepsy in our hospital(the third hospital of JILIN University) from 2011 January to 2015 December, ruled out 657 cases who can not clear etiology due to the imperfect medical records, and 899 patients whose starting age >18 years old were included in the study. Combined with the clinical symptoms and EEGchanges, 734 patients conform to the clinical manifestation and EEG changes in accordance with the International League against epilepsy seizure classification standard in 2014. All of the patients were collected detail medical history and following –up,and recorded the name, age, nationality,home address,past medical history,clinical manifestations, EEG, imaging examination, routine immunization,etc. Summarize and analyze the causes of epilepsy, and relevant comparison research into two documents(<The statistics of 2810 cases of epilepsy>,<The cause analysis of 5572 patients with epilepsy>).All data were analyzed by statistical software SPSS 19.0,which enumeration data were described by percentage(%),and statistical inference respectively used t test,chi square test. p<0.05 was considered statistically significant. Results:1.In 899 patients, there were 109 patients in epileptic seizure, 56 cases for disease acute stage in patients with secondary epilepsy. 734 patients conform to the clinical manifestation and EEG changes in accordance with the International League against epilepsy seizure classification standard in 2014.2. The cause analysis showed that idiopathic epilepsy in 1.09%, cryptgenic epilepsy in 23.29%, stroke in 38.74%, head trauma in 28.26%, brain tumor in 9.55%, post craniotomy in 10.09%, cerebral infection in 6.31%,cerebral arteriovenous malformation in 3.78%, focal cortical dysplasia in 3.24%, cerebral cysticercosis in 2.34%, hippocampal lesions in 1.62%, brain atrophy in 1.26%, chronic alcoholism in 0.72%,metabolic diseases in 0.54%,hypoxic encephalopathy in 0.36%, demyelinating central nervous system lesions in 0.18%.3. 734 cases of patients conformed to epilepsy classification standard, 198 examples in young group, 326 cases in middle-aged group, 210 cases in elderly group.Among them, the primary cause of youth is head trauma, and elderly group in the majority is cerebrovascular disease, and etiology of all ages constitute the proportion is also different.4. Comparing with 70 s literature statistics: Secondary epilepsy newly increased eight kinds of causes,such as brain surgery, vascular malformations, hippocampal lesion, brain atrophy, chronic alcoholism, metabolic disease, anoxic encephalopathy and demyelinating disease of the central nervous system. And it reduced four kind of the cause of secondary epilepsy in the 70 s, for example, the family degeneration diseases, lead poisoning, rheumatic heart disease, a febrile convulsion.5. Comparing with epilepsy center statistics: According to the results of the epilepsy center statistics, secondary epilepsy increased the neurocutaneous syndrome and other rare can’t categorize the cause(including cerebral palsy, mental retardation, basal ganglia calcification, hydrocephalus, nitric oxide poisoning, brain mitochondria myopathy, radiation encephalopathy, msa, etc.). Comparison of the two causes, comprehensive hospitals have a higher proportion of cerebrovascular disease, and brain tumor, brain trauma, proportion of the central nervous system infection after the cause is low. Conclusion:1, the common causes of secondary epilepsy in comprehensive hospital in turn for cerebrovascular disease, head trauma, brain tumor, brain surgery, after the central nervous system infection, vascular malformations, brain developmental disorders, brain cysticercosis, hippocampal lesions, etc. And the composition of different age paragraph the cause than obviously different, young people to see more, head trauma, the elderly in cerebrovascular disease.2, Compared with the 70 s, the cause of adult epilepsy spectrum and the proportion has changed. Cerebrovascular disease, brain injury ratio increased, the parasitic disease and brain tumor, brain, brain developmental disorders and central nervous system infection presents downtrend; With the constant improvement of the medical treatment level, vascular malformations and hippocampal lesion, demyelinating disease of the central nervous system has known by people gradually.3, comprehensive hospital in adults with epilepsy higher proportion of source sex epilepsy, still need to intensive research on epilepsy due to learn.