@article {Wagner10.1212 / WNL。0000000000206838，作者= {Wagner, Anna S和Baumann, Sira M和Semmlack, Saskia和Frei, Anja I和R{\"u}egg, Stephan和Hunziker, Sabina和Marsch, Stephan和Sutter, Raoul}，标题={比较重症监护病房中孤立性癫痫发作和癫痫持续状态的患者:一项观察性队列研究}，位置-id = {10.1212/WNL。0000000000206838}， year = {2023}， doi = {10.1212/WNL。0000000000206838}，出版商= {Wolters Kluwer Health, ltd .代表美国神经病学学会}，摘要={目的:评估癫痫持续状态(SE)在重症监护病房(ICU)发作半岛投注体育官网的危重成人患者中的频率，并确定孤立性癫痫发作患者与SE患者之间的临床差异。方法:从2015年到2020年，通过筛查所有数字医疗、ICU和脑电图记录，确定了瑞士三级护理中心所有重症监护医师和/或咨询神经科医生报告的孤立性癫痫或SE的连续成年ICU患者。排除<18岁和缺氧缺血性脑病所致肌阵挛但脑电图无癫痫发作的患者。孤立性癫痫发作和SE的频率以及与SE相关的癫痫发作时的临床特征是主要结局。进行单变量和多变量逻辑回归以确定与SE出现的关联。结果:404例癫痫患者中，SE占51%。与单纯癫痫发作患者相比，SE患者Charlson共病指数(CCI)中位数更低(3比5,p <0.001)，致死性病因更少(43.6%比80.5 %，p <0.001)，格拉斯哥昏迷评分中位数更高(7比5,p <0.001)，发热频率更高(27.5%比7.5 %，p <0.001)， ICU和住院时间中位数更短(ICU: 4比5天，p=0.039;住院时间:13天比15天，p=0.045)，且更容易恢复到病前功能(36.8%比17%，p <0.001)。多变量分析显示SE的优势比(OR)随着CCI (OR=0.91, 95%可信区间[CI] 0.83-0.99)、致死病因(OR=0.15, 95% CI 0.08-0.29)和癫痫(OR=0.32, 95% CI 0.16-0.63)的增加而降低。在排除癫痫作为ICU入院原因的患者后，全身炎症是SE的另一个相关因素(ORfor CRP=1.01, 95% CI 1.00-1.01; ORfor fever=7.35, 95\%CI). While fatal etiologies and increasing CCI remained associated with low odds for SE after excluding anesthetized patients and hypoxic-ischemic encephalopathy, inflammation remained associated in all subgroups except patients with epilepsy.Conclusions: Among all ICU patients with seizures, SE emerged frequently and seen in every second patient. Besides the unexpected low odds for SE with higher CCI, fatal etiology, and epilepsy, the association of inflammation with SE in the critically ill without epilepsy represents a potential treatment target and deserves further attention.}, issn = {0028-3878}, URL = {//www.ebmtp.com/content/early/2023/03/06/WNL.0000000000206838}, eprint = {//www.ebmtp.com/content/early/2023/03/06/WNL.0000000000206838.full.pdf}, journal = {Neurology} }