| Epilepsy status(SE)is the most common acute and severe neurology,with the deepening of our understanding of epilepsy,the definition of epilepsy status is also constantly improving,the International League Against Epilepsy proposed a new status of epilepsy Definition in 2001:“more than the majority of the seizure of this type of attack when the patient takes time,the onset has not stopped clinical signs,or repeated epileptic seizures,at the seizure of the central nervous system function did not return to the normal baseline.” Persistent seizures often associated with infection,electrolyte imbalance,acid-base balance disorders,multiple organ failure,leading to the occurrence of refractory epilepsy,increased patient mortality.Among them,People are not fully aware of the continuous status of focal epilepsy,leading to the disease in the early without diagnosis and active treatment,patients often leave serious neurological dysfunction,like post-epileptic nerves dysfunction(PEND);On the other hand may also be over-treated,leading to respiratory depression and other complications.Among them,epilepsia partialis continua,EPC,also known as Kojewnikow syndrome(KS),as a type of focal epilepsy more and more people's attention.Purpose:We retrospectively analyzed the clinical,EEG and imaging features of patients with Kojewnikow syndrome,analyzed the relevant factors affecting prognosis,and provided experience for the prevention,diagnosis and treatment of Kojewnikow syndrome.Method:Analysis cases of focal epilepsy status in our hospital(Jilin University Sino-Japanese Friendship Hospital)from September 1,2013 to February 1,2017,excluding medical records is extremely imperfect,combined with its clinical symptoms and changes in EEG,will meet the 2001 epilepsy diagnosis and classification criteria,and in line with Thomas [1] proposed KS syndrome with twomajor characteristics of the case into the study.Detailed examination of medical records,some patients were followed up by telephone tracking,respectively,to record the patient's sex,age of onset,etiology,incentives,affected parts of seizure,whether combined with other symptoms,EEG changes,imaging changes,treatment,duration of attack,time of seizure control,antiepileptic drugs and prognosis,summarizes the clinical,imaging and EEG characteristics of KS,and analyzes the sex,age of onset,etiology,incentives,EEG features,imaging features,state of consciousness,duration of seizure,time of seizure control,frequency characteristics of the seizure,antiepileptic drugs on prognosis of KS.Result:1.Clinical features: the ratio of man to female is 1.69: 1,mean age(51.9 ±21.55)years old.41-60 years old Group and more than 60 years old group is the most common,each accounted for 37.1%;acute symptoms and chronic symptoms are the most common,each accounting for 34.3%;infection and irregular application of antiepileptic drugs is the most common incentives of KS syndrome;the most common affected parts is the face,upper limbs and face,each accounting for 20%,involving the proximal limb more than the distal limbs,the left side is more than the right side;9 cases(25.7%)combined with other types of seizures during the onset;23 cases(65.7%)with varying degrees of disturbance of consciousness,the remaining 12cases(34.3%)were conscious during the seizure.There was group of 26 cases(74.3%)showing continuous seizure,9 cases(25.7%)were cluster.2.Electroencephalogram features:For the intermittent EEG,30(85.7%)EEG abnormalities in this group,,10 cases of bilateral abnormalities,12 cases of right abnormalities,8 cases of left abnormalities,abnormal EEG mainly slow wave mainly(57.1%),focal slow wave more common;Part of cases underwent EEG examination in seizure period,the presence of periodic epileptiform discharges(PLEDs)in the contralateral side of myoclonus is common.3.Imaging features: Abnormal imaging examination in 31 cases(88.6%),normal 4 cases(11.4%).Among them,23 cases(65.7%)were only cortical abnormalities,mainly in the the frontal and parietal cortex abnormalities.There were3 cases(8.6%)of subcutaneous structural abnormalities,and 5 cases(14.3%)of cortical and subcutaneous structures were abnormal.The right side of the abnormity ismore common.compared with clinical manifestations,EEG,60% of the associated imaging changes,the frontal and parietal cortex abnormalities is common.4.Treatment and prognosis: Most patients with antiepileptic drugs during the attack,a small number of cases to improve their own or improved after the removal of the cause,22 cases(62.9%)patients with more than two kinds of antiepileptic drugs,the most common treatment is intravenous administration of sodium valproate,Second,the muscle is injected with phenobarbital.In addition to 2 cases of death and 1 case of discharge,10 cases(31.2%)with PEND,the most common PEND is TODD paralysis.5.Related factors influencing prognosis:Sex,etiology,intermittent EEG changes,image examination,frequency characteristics of the seizure,antiepileptic treatment has nothing to do with whether or not PEND(P>0.05).State of consciousness,the time of seizure control is related to whether or not PEND(P<0.05).Conclusion:1.KS prone to middle and elderly patients with epilepsy,infection and irregular application of antiepileptic drugs is the most common incentiv of KS.face,upper limb is most often involved.Intermittent EEG changes are most common in slow waves,suggesting that the brain is partially dysfunctional.2.The majority of patients with more than two kinds of antiepileptic drugs.Part of the KS left PEND,the most common is TODD paralysis.3.State of consciousness,seizure control time may affect the prognosis,active control of KS is the key to improve the prognosis. |
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