Influencing Factors Involved in the Progression of Epileptic Seizure at the Acute Phase of Encephalitis into Postencephalitic Epilepsy / 中风与神经疾病杂志

ABSTRACT

@#Objective To investigate the factors that affect the progression of epileptic seizure at the acute phase of encephalitis into postencephalitic epilepsy.Methods A retrospective analysis was conducted to investigate the clinical data of 141 patients who were admitted to the First People’s Hospital of Yunnan Province and the First Affiliated Hospital of Kunming Medical University from January 2010 to June 2019，diagnosed as autoimmune encephalitis or viral encephalitis in the acute phase with epileptic seizure and treated with immunotherapy. The 141 patients were divided into 2 groups according to whether their epileptic seizure progressed to postencephalitic epilepsy. Logistic regression analysis was applied to investigate the factors that affect the progression of epileptic seizure at the acute phase of encephalitis into postencephalitic epilepsy.Results The epileptic seizure of 25 patients（17.73% of all 141 patients） progressed to postencephalitic epilepsy. The results of multi-factor Logistic regression analysis show that the risk factors involved in the progression of epileptic seizure included：a fever before treatment（OR=3.288，95％CI=1.116～9.687，P=0.031） and high seizure frequency（≥10 times/day）（OR=4.564，95％CI=1.263～16.491，P=0.021）. Compared with a course of antiepileptic drugs for less than 6 months，a course of antiepileptic drugs for 6-12 months（OR=0.672，95％CI=0.064～7.024，P=0.740） or above（OR=3.049，95％CI=0.906～10.261，P=0.072） did not affect the development of postencephalitic epilepsy. Compared with the patients with no fever before treatment，those with fever were more prone to disturbance of consciousness（P<0.001），status epilepticus（P=0.023） and a head MRI showing inflammatory lesions（P=0.007）.Conclusion Therefore，a fever before treatment and high seizure frequency（≥10 times/day） are identified as the risk factors causing postencephalitic epilepsy. The length of course of antiepileptic drugs does not affect the incidence of postencephalitic epilepsy，suggesting that it is unnecessary to prevent postencephalitic epilepsy by long-term use of antiepileptic drugs.