New-onset seizure in hospitalized patients

J Korean Neurol Assoc > Volume 15(2); 1997 > Article

Journal of the Korean Neurological Association 1997;15(2): 267-274.

입원 기간 중 발생한 첫 경련발작

김종홍, 김제, 이애영, 김재문

충남대학교 의대 신경과

New-onset seizure in hospitalized patients

Hoon-Bok Lee, M.D., Jong-Hong Kim, M.D., Jei Kim, M.D., Ae-Young Lee, M.D., Jae-Moon Kim, M.D.

Department of Neurology, College of Medicine, Chungnam National University

Abstract

Systemic illnesses and preexisting disorders affecting the brain may decrease the seizure threshold in some conditions. For the non-neurologist, patient with new-onset seizure (NOS) is troublesome problem to manage properly. To verify the characteristics of patients with NOS, we analyzed their clinical features. From Jan. 1991 to Jul. 1995, 47 patients were consulted to the neurological department because of their NOS during the admission. We retrieved the medical records, laboratory data and consultation sheets. The most common cause of the NOS was a metabolic disorder (18 patients, 38.3%) and was followed by a previous cerebrovasular disease (6 patients, 12.8%). Ceneralized tonic-clonic seizure occurred in more than half of the patients (55.3%). Fifteen out of 26 initial EEGs revealed diffuse slowings only, whereas only four patients showed focal epileptiform discharges. Status epileptics occurred in seven patients and five of them died. Six patients out of 17 patients with metabolic causes died, comparing five patients out of 27 patients with other causes. It is suggested that the NOS associated with metabolic causes are most common in hospitalized patients and were associated with poor prognosis.