| Objectives:To study the clinical characteristics, treatment and prognosis of epilepsy in the patients with post-encephalitic epilepsy(PEE). Methods :eighty three epilepsy patients with convulsive seizures as the acute symptom admitted to Neurological department of our hospital from November 2010 to July 2015 were included in this study. Their clinical data and prognosis those known by telephone follow-up were retrospectively analyzed. Results:We selected 83 patients with 23 in acute epilepsy(27.71%) and 67 in post-encephalitic epilepsy(72.29%). The 83 cases of epilepsy with encephalitis:(1) 52 males and 31 females are included, male:female=1.68:1. There was no statistically significant between age and post-encephalitic epilepsy. The younger and elderly patients(age<40 or >60) were more likely to develop to the post-encephalitic epilepsy.(2) The onset of disease:all patients were with acute or sub-acute onsets. Most patients showed at least 2 symptoms, includ ing fever, headache, seizures, disturbance of consciousness, mental and behavioral abnormalities. 28 patients were in a single form of onset, 55 patients with 2 or more than 2 forms of onset.(3) There was statistical significance between etiology and prognosis groups. Patients with autoimmune encephalitis were most likely to progress to the PEE.(4) Secondary GTCS was the main part of the form of seizures. Patients with simple partial seizures were less likely to beco me PEE, while patients with GTCS and secondary GTCS were on the opposite.(5) The number of seizures were obviously linked to the prognosis of patients with obvious link. The probability of patients with PEE were increasing with the increasing number of seizures.(6) The rate of the detection by MRI was relatively higher than C T,76 cases were checked by MRI, in which 35 cases showed positive results. 14 cases were detected with bilateral lesions, 21 cases were unilateral lesions. The lesions of encephalitis can be unilateral or bilateral, and the distribution can be symmetrical or not. The lesions were mainly located in the frontal lobe, occipital lobe, temporal lobe and insular lobe. The typical manifestations showed focal edema, which were high signal on T2W1 or the mixed signal when bleeding. It was no evidence proved that the imaging findings and PEE had statistical correlation.(7) The typical change on EEG is based on the slow delta basic rhythms. There were sharp waves, spike waves, sharp slow and spike slow wave complexes appearing on the local or bilateral hemisphere, which can be paroxysmal or continuous. The more abnormal the EEG showed, the greater possibility of PEE.(8) Treatment: 37 patients used antiepileptic drugs, in which 26 cases reflected different degrees of improvement. The effective rate is 70.27%.(9) prognosis: 23 patients with epilepsy were controlled within 2 weeks after discharging, and 60 patients with more than 2 weeks. Conclusions:(1) The results of the study showed that patients with epilepsy in the acute phase of encephalitis had high possibility to develop to PEE(72.29%).These patients need regulate anti-epilepsy treatment.(2) The factors related to PEE included age, etiology, onset form, frequency and duration of seizures, and abnormal changes of EEG.(3) Patients with epilepsy in acute encephalitis in young or old age(age < 40 or > 60 years old) had more probability to PEE than patients in middle age.(4) The cause of encephalitis had significant impact on the progress of PEE. Patients with autoimmune encephalitis were the most likely to develop into PEE.(5) Patients with GTCS and secondary GTCS were more likely to become PEE. With the increasing number of seizures, the possibility of the development into PEE was increasing. The longer time of the seizures, the higher probability that the patient progress to the PEE.(6) The abnormal of EEG was related to the condition of patients. The more severe changes showed on EEG, the more possible for patients to develop into PEE. |
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