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J Korean Neurol Assoc. 1984;2(2):164-174.
- A Clinical Study on Status Epilepticus
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Ho Jin Myoung, M.D., Oh Sang Kwon, M.D.
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Department of neurology, Seoul National University
- 대발작성 간질중첩증에 대한 임상적 연구
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명호진, 권오상
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서울대학교 신경과.
- Abstract
- The etiological and precipitating factors, clinical features and outcomes of 48 patients over the age of 17 years with generalized major motor status epilepticus were studied.
Eleven patients were regarded to have idiopathic epilepsy and the other thirty-seven had
symptomatic epilepsy due to intracranial infection, cerebrovascular diseases, cerebral tumors,
cerebral trauma, metabolic disorders, unknown and others. Most frequent causes were
intracranial infection including nonspecific inflammatory granuloma, cerebral cysticercosis, viral
encephalitis and sequela of previous meningitis.
The major single precipitating factor of the status was abrupt discontinuation of
antiepileptic drugs and this accounted for 57% of the status in 30 patients with previous
seizures. Other factors were upper respiratory infection, alcohol intake and physical
exhaustion. In 18 patients without history of previous seizure, only six had obvious
precipitating factors.
Among 48 patients, sixteen patients showed primary generalized tonic-clonic status and
the remaineder had generalized tonic-clonic status with focal onset. Twenty-five patients
(78%) in the latter group had apparent causes and brain C.T. scans revealed structural lesions
in 68% of 28 patients in the latter group. Therefore it is suggested that patients showing the
status with focal onset must be screened with laboratory studies as fully as possible,
including brain C.T.
In 41 patients who had no apparent ifectious process, the episodes of status were
accompanied by hyperthermia (69%) and transient leukocytosis (65%). In 16 of them,
cerebrospinal fluid was examined and a status-induced cererbrospinal fluid pleocytosis was
observed in 3 patients.
Forty-two patients in this series recoverd without neurological sequelas from the status
and three had some sequelae at the time of discharge, including disturbances of recent
memory, calculation, judgement and emotion. Three patients (6%) who died from the status
were having idiopathic epilepsy, viral encephalitis or subarachnoid hemorrhage, respectively. "
Keywords :
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