성인경련의 원인적 고찰 |
서정규, 이상도, 박영춘 |
계명대학교 신경과 |
Etiologic Analysis of Adult Onset Seizure |
Jung-Kyue Seo, M.D., Young-Choon Park, M.D., Sang-Do Lee, M.D |
Department of Neurology, Kemyung University |
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Abstract |
A clinical study was done on 161 patients (male 94, female 67) with the first onset of seizure over the age of 16 who were admitted to Keimyung University Hospital from 1979 to 1983 in order to analyze the causative factors, the age distribution at onset, the seizure pattern and E.E.G. findings. The results were summarized as follows.
1. The etiological factors of 161 seizure patients revealed metabolic encephalophaties 75 cases
(46.6%), cerebrovascular disease 26 cases (16.2%), unknown cause 21 cases (13%), CNS
infectious disease 17 cases (10.6%), posttraumatic seizure 12 cases (7.5%), brain tumor proved
by brain biopsy 8 (5%) and hysteric seizure 2 cases in order of frequency.
2. Among the 75 cases of metabolic encephalopathies, the most common cause was drug
intoxication (34 cases), followed by alcohol withdrawal seizure (21 cases), water intoxication
(5 cases), uremia and hypocalcemia (4cases respectively), hepatic encephalopathies (3 cases)
and then hypoglycemia and anoxia (2 cases respectively) in order of frequency. Among the 26
cases of cerebrovascular disease, spontaneous subarachnoid hemorrhage was presented in 9
cases, intracerebral hemorrhage and cerebral infarction in 7 cases respectively and
arteriovenous malformation in 3 cases. Among the 17 cases of CNS infectious diseae,
meningitis was presented in 9 cases, Japanese B encephalitis in 3 cases, paragonimiasis in 2
cases, and then cerebral cysticercosis, tuberculoma, and focal cerebritis in 1 case respectively.
Among the 8 cases of brain tumor, meningioma was presented in 5 cases, oligodendroglioma,
glioblastoma multiforme and epidermoid cyst in 1 case respectively.
3. The mean age at the onset of each causes of seizure revealed metabolic encephalopathies
38 yrs. CNS infectious disease 33 yrs, posttraumatic seizure 34 yrs, arteriovenous
malformation 23 yrs, brain tumor 42 yrs, and cerebrovascular disease 54 yrs.
4. The most frequent seizure pattern of 161 patients was the generalized seizure in 126 cases
(78.3%) followed by the partial elementary seizure in 29 case and the partial seizure with
secondary generalization in 6 cases. The incidence of partial seizure was slightly higher than
the generalized seizure in brain tumor and CNS infectious disease. 5. There were no
correlation between the E.E.G. degree and causative factors of seizure. |
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