Bodilsen, Jacob Duerlund, Lærke Storgaard %A Mariager, Theis %A Brandt, Christian Thomas %A Wiese, Lothar %A Petersen, Pelle Trier %A Larsen, Lykke %A Hansen, Birgitte Rønde %A Omland, Lars Haukali %A Tetens, Malte Mose %A Jørgensen, Rasmus Langelund %A Leth, Steffen %A Nielsen, Henrik %T脑脓肿后癫痫的危险因素和预后:一项全国人群队列研究%D 2023 %R 10.1212/WNL。0000000000206866 %J神半岛投注体育官网经病学%P 10.1212/WNL。背景和目的:脑脓肿患者癫痫多发，但危险因素和预后尚不明确。这项研究调查了脑脓肿幸存者癫痫的危险因素和相关预后。方法:在全国范围内，使用基于人群的医疗保健登记，计算1982年至2016年30天脑脓肿幸存者中癫痫的累积发病率和原因特异性调整危险率比(adj. HRRs)， 95%置信区间(ci)。通过回顾2007年至2016年住院患者的病历，丰富了数据中的临床细节。将癫痫作为时间依赖变量，对调整后的死亡率比率(MRRs)进行检查。结果:该研究包括1179名30天脑脓肿幸存者，其中323人(27%)在中位数为0.76年后发生新发癫痫(四分位数范围[IQR] 0.24-2.41)。因脑脓肿入院时，癫痫患者的中位年龄为46岁(IQR 32-59岁)，而无癫痫患者的中位年龄为52岁(IQR 33-64岁)。女性在癫痫患者和非癫痫患者中的比例相似(37%)。癫痫的HRRs在脑脓肿抽吸或切除组为2.44 (95% CI 1.89-3.15)，酗酒组为2.37 (95% CI 1.56-3.60)，既往神经外科或颅脑外伤组为1.75(1.27-2.40)，中风组为1.62(1.17-2.25)，20-39岁组为1.55(1.04-2.32)。 Cumulative incidences were increased in patients with alcohol abuse (52% vs 31%), aspiration or excision of brain abscess (41% vs. 20%), previous neurosurgery or head trauma (41% vs. 31%), and stroke (46% vs. 31%). Analysis using clinical details from medical record review of patients from 2007 through 2016 demonstrated adj. HRRs of 3.70 (2.24-6.13) for seizures at admission for brain abscess and 1.80 (1.04-3.11) for frontal lobe abscess. In contrast, adj. HRR was 0.42 (0.21-0.86) for occipital lobe abscess.Using the entire registry-based cohort, patients with epilepsy had an adj. MRR of 1.26 (1.01-1.57).Discussion: Important risk factors for epilepsy were seizures during admission for brain abscess, neurosurgery, alcoholism, frontal lobe abscess, and stroke. Epilepsy was associated with increased mortality. Anti-epileptic treatment may be guided by individual risk profiles and specialized follow-up is highlighted by increased mortality in survivors with epilepsy. %U //www.ebmtp.com/content/neurology/early/2023/02/21/WNL.0000000000206866.full.pdf