| Objective: Through the correlation study on the severity of cognitive dysfunction in adult epileptic patients with FS history,it is clear whether this kind of patients have more serious cognitive dysfunction and its related influencing factors,in order to guide the clinical diagnosis and treatment.Methods: From August 2017 to October 2018,60 patients with adult epilepsy admitted to the epilepsy clinic of our hospital were taken as the subjects of this study.The clinical data of the patients were recorded,such as sex,age,educational level,age of onset,course of disease,frequency of attack,duration of attack,type of attack,medication,electroencephalogram(EEG)and imaging findings,and neuropsychological test.Scores(mini mental state scale(MMSE),Montreal cognitive evaluation scale(Mo CA),self-rating anxiety scale(SAS),self-rating depression scale(SOS).The subjects were divided into two groups:adult epilepsy with FS history(FS group)and adult epilepsy without FS history(non-FS group).The data were statistically analyzed.Results:(1)There were 22 cases in FS group,including 11 cases of male and 11 cases of female,38 cases of non-FS group,18 cases of male and 20 cases of female.The average age of FS group was(32.91 ±10.58)years old,the average age of non-FS group was(32.55 ±11.25)years old;In the FS group,there were11 cases of middle school education and below,11 cases of high school education and above.In the non-FS group,there were 11 cases of junior middle school education and 25 cases of high school education.(2)In epileptic patients,drug treatment regimen and FS history are correlated with cognitive function in adult epileptic patients.Cognitive function decreased in 27 cases,including 11 cases of single medication and 16 cases of combined medication.33 patients with normal cognitive function,including 27 cases of single medication and 6 cases of combined medication,chi-square test showed that ?~2 = 10.790,P = 0.001,P < 0.05,between the two groups,?~2 = 10.790,P = 0.001,P < 0.05,respectively.There were 15 cases in FS group and 12 cases in non-FS group.There were 7 cases in FS group and 26 cases in non-FS group.the chi-square test showed that ? 2 = 7.542,P < 0.05,the difference was statistically significant.(3)In epileptic patients,the age of onset,course of disease,seizure duration,seizure frequency,seizure type,discharge location,interictal EEG abnormality and other factors were not correlated with cognitive function of epileptic patients.There were 27 patients with decreased cognitive function and 33 patients with normal cognitive function.The onset age of epileptic patients with cognitive decline was 23(20,30)years,the average course of disease was 6(1,17)years,the duration of seizures was(3 ± 2)minutes,the frequency of seizures was 36(12,72)times per year,and there were 10 cases of focal seizures.There were 13 cases of secondary generalized seizures,4 cases of generalized seizures,22 cases of temporal lobe discharge,5 cases of frontal lobe discharge,3 cases of mild abnormality of interictal EEG,14 cases of moderate abnormality and 10 cases of severe abnormality,and the first age of epileptic patients with normal cognitive function was 22(18,28)years old.The average course of disease was 2(1,5)years,the duration of seizures was(4±2)minutes,the frequency of seizures was 12(3,48)times per year,there were 11 cases of focal seizures,20 cases of secondary generalized seizures,2cases of generalized seizures and 23 cases of temporal lobe discharges.Frontal lobe discharge in 10 cases,4 cases of mild abnormality,19 cases of moderate abnormality and 10 cases of severe abnormality of EEG in interictal period.The P respectively to 0.343,0.075,0.509,0.082,0.478,0.294,0.931,respectively.there was no significant difference between the two groups(P >0.05).(4)The cognitive impairment in FS group was more severe than that in non-FS group.The total score of MMSE was(28.73±1.39)in FS group and(28.87±1.23)in non-FS group.the chi-square test showed that ?~2 =-0.408,P= 0.685,there was no significant difference between the two groups.The total score of Mo CA in FS group was(24.23±2.76),and the total score of Mo CA in non-FS group was(25.97±2.41).Chi-square test showed that ?~2 =-2.564,P= 0.013,P < 0.05,the difference was statistically significant.(3)In FS group,the scores of visual space and executive ability,naming ability and attention were(3.91±1.06),(2.86±0.35)and(5.23±0.87),respectively,and the scores of visual space and executive ability,naming ability and attention were(3.91±1.06),(2.86±0.35)and(5.23±0.87),respectively.The score of language structure was(2.09±0.87),the score of abstract ability was(0.73±0.63),and the score of delayed recall was(2.73±1.35).The score of orientation force was(6±0);In the non-FS group,the scores of visual space and executive ability,naming ability,attention and language structure were(4.13 ± 1.12),(3 ± 0),(5.71 ± 0.61)and(1.26 ± 0.72)respectively,and the scores of visual space and executive ability were(4.13±1.12),(3±0),(5.71±0.61)and(1.26±0.72),respectively.The score of abstract ability was(1.26±0.72).The score of delayed recall was(2.89 ± 1.23),and the score of orientation was(6 ± 0).There was significant difference in the scores of attention,language structure and abstract ability between the two groups(P <0.05).(4)In FS group,complex febrile convulsion had a more severe effect on cognitive impairment of adult epilepsy with FS history.There were 9 cases of simple febrile convulsion in the type of FS,and the score of Mo CA was(24.36±2.82).There were 13 cases of complex febrile convulsion,and the score of Mo CA was(24 ± 2.83).T test showed that T = 2.672,P < 0.05,there was significant difference between the two groups.(5)In FS group,sex and body temperature at the time of attack had no effect on cognitive impairment of adult epilepsy with FS history.There were 12 males and 10 females.the results of independent sample t test showed that T = 0.654,P = 0.521,the difference was not statistically significant.There were 12 cases with body temperature < 38.5 ? at the onset of FS and 10 cases with FS onset age ? 38.5 ?.T test showed that T = 0.499,P = 0.623,P > 0.05,and there was no significant difference between the two groups.(6)In FS group,14 patients with FS ? 3 years old,the score of Mo CA was(24.36 ± 2.82),the score of abstract ability was(0.9 ± 0.47);There were 8patients whose initial age of FS was more than 3 years old.the score of Mo CA was(24±2.83),and the score of abstract ability was(0.4±0.74).The cognitive impairment of the two groups with different FS onset age was compared.the independent sample t test showed that there was no significant difference in the total score of Mo CA between the two groups(T = 0.286 P ?=0.778),but there was no significant difference in abstract ability between the two groups(P< 0.05).(7)There were 2 patients with hippocampal sclerosis and atrophy in FS group and 4 patients with hippocampal sclerosis and atrophy in non-FS head MRI group.the chi-square test showed that ?~2 = 0.072,P = 0.789,the results showed that there was no significant difference in hippocampal sclerosis and atrophy between the two groups of MRI.Conclusions:(1)The history of febrile seizures is an independent risk factor for cognitive dysfunction in patients with epilepsy.Patients with epilepsy with a history of febrile seizures have more severe cognitive dysfunction,mainly in attention,language structure,abstract ability and so on;(2)Body temperature and sex had no effect on the cognitive function of epilepsy after febrile convulsion.The type of febrile seizures had an effect on the cognitive function of adult epileptic patients with FS history,and the cognitive function decreased more seriously in patients with complex febrile seizures;(3)the age of onset of febrile convulsion had an effect on the abstract ability of epileptic patients after febrile convulsion,and the decrease of abstract ability was more severe when the initial age of FS was more than 3 years old;(4)Age of febrile seizures had an effect on the time of epilepsy after FS,while the type of seizures and seizures in gender and febrile seizures had no effect on the development of epilepsy after febrile seizures;(5)Head MRI hippocampal sclerosis and atrophy in adult epileptic patients with a history of febrile seizures were not significantly different from those in adult epilepsy without a history of febrile seizures. |
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