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目的:分析药物诱发癫痫样发作的相关危险因素。方法:检索1997年至2007年CNKI和CMB收载的药物诱发癫痫样发作患者148例的资料,对患者的年龄、性别、原患疾病、诱发癫痫药物、药物剂量、联合用药,癫痫发作类型、发作时间和持续时间及转归进行回顾性分析。结果:148例患者中,男82例,女66例,平均年龄(40.16±24.08)岁,有癫痫病史15例。诱发癫痫样发作居前三位的药物为抗微生物药物82例(其中喹诺酮类39例),占55.41%,中枢神经系统药物34例(其中抗精神病药物20例),占22.97%,麻醉药8例(其中氯胺酮6例),占5.41%;药物诱发癫痫样发作类型以全面强直-阵挛性发作为主,共120例(81.08%),其次为复杂部分性发作15例(10.14%);患者年龄<19岁32例(21.6%),年龄≥60岁52例(35.14%);超剂量用药21例(14.19%);45例联合用药患者中有10例出现癫痫样发作。癫痫发作时间为首次用药后3 min至6个月,持续时间为4 s至20 min。147例癫痫样发作患者经停药及对症处理症状均好转或痊愈,1例因肺部感染,循环衰竭死亡。结论:药物诱发癫痫样发作可能与药物对中枢神经系统的作用、患者的年龄(老年或未成年)、癫痫病史、原患疾病、药物剂量过大以及联合用药等因素相关。
Objective: To analyze the related risk factors of drug-induced epileptic seizures. Methods: The data of 148 cases of drug-induced epileptic seizures carried by CNKI and CMB from 1997 to 2007 were retrieved. The age, gender, original disease, induced epilepsy, drug dose, combination therapy, seizure type, Time and duration of attack and outcome were retrospectively analyzed. Results: Of the 148 patients, 82 were male and 66 were female, with an average age of (40.16 ± 24.08) years and a history of 15 epilepsy. Among the top three drugs induced by epilepsy, 82 were antimicrobial drugs (including quinolones 39), accounting for 55.41%; central nervous system drugs 34 (antipsychotics 20), accounting for 22.97%; narcotics 8 (Including ketamine in 6 cases), accounting for 5.41%. The type of drug-induced epilepsy was dominated by total tonic-clonic seizures, with 120 cases (81.08%) followed by 15 cases (10.14%) with complicated partial seizures. Thirty-two patients (21.6%) were older than age 19, 52 (35.14%) were over 60 years old, 21 were over-dosed (14.19%), and 10 were epileptic seizures in 10 of 45 patients. Epileptic seizure time for the first time after 3 min to 6 months, the duration of 4 s to 20 min. 147 cases of epileptic seizures in patients with withdrawal and symptomatic treatment were improved or cured symptoms, 1 case of death due to pulmonary infection, circulatory failure. Conclusions: Drug-induced epileptic seizures may be related to the effects of drugs on the central nervous system, the patient’s age (old age or minor age), history of epilepsy, previous illness, overdosage, and combination therapy.