脑炎后癫痫诊断与治疗进展_Journal of Epilepsy

Authors：

陈豆豆 ,  胡越

重庆医科大学附属儿童医院神经内科；儿童发育疾病研究教育部重点实验室；国家儿童健康与疾病临床医学研究中心；儿童发育重大疾病国家科技合作基地；儿科学重庆市重点实验室（重庆 400014）;

Corresponding author：

胡越, Email: huyue915@163.com

Keywords：

脑炎后癫痫; 发病机制; 危险因素; 治疗

DOI：

10.7507/2096-0247.20200056

Video：

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脑炎后癫痫（Postencephalitic epilepsy，PEE）是指脑炎急性期后出现癫痫发作，是急性脑炎常见的后遗症，部分可发展为难治性癫痫。病毒感染引起的 PEE 是最常见类型。文章总结了 PEE 的病因、流行病学、发病机制，PEE 发生相关的危险因素以及用药指征，以期为该疾病的诊断、治疗及预后评估提供临床参考。

Citation： 陈豆豆, 胡越. 脑炎后癫痫诊断与治疗进展. Journal of Epilepsy, 2020, 6(4): 345-349. doi: 10.7507/2096-0247.20200056 Copy

1.	Rao S, Elkon B, Flett KB, et al. Long-term outcomes and risk factors associated with acute encephalitis in children. Journal of the Pediatric Infectious Diseases Society, 2017, 6(1): 20-27.
2.	Fowler A, Stodberg T, Eriksson M, et al. Long-term outcomes of acute encephalitis in childhood. Pediatrics, 2010, 126(4): e828-e835.
3.	Lee W, Yu T, Chang W, et al. Risk factors for postencephalitic epilepsy in children: A hospital-based study in Taiwan. European Journal of Paediatric Neurology, 2007, 11(5): 302-309.
4.	Chen YJ, Fang PC, Chow JC. Clinical characteristics and prognostic factors of postencephalitic epilepsy in children. J Child Neurol, 2006, 21(12): 1047-1051.
5.	Pillai SC, Mohammad SS, Hacohen Y, et al. Postencephalitic epilepsy and drug-resistant epilepsy after infectious and antibody-associated encephalitis in childhood: Clinical and etiologic risk factors. Epilepsia, 2016, 57(1): e7-e11.
6.	Singh TD, Fugate JE, Hocker SE, et al. Postencephalitic epilepsy: Clinical characteristics and predictors. Epilepsia, 2015, 56(1): 133-138.
7.	Pedersen E. Postencephalitic Epilepsy. Epilepsia, 1964, (5): 43-50.
8.	Yoshioka M, Kuroki S, Mizue H. Clinical and electroencephalographic studies of postencephalitic epilepsy. Acta Paediatr Jpn, 1989, 31(4): 480-483.
9.	Lin K, Lin J, Hsia S, et al. Effect of antiepileptic drugs for acute and chronic seizures in children with encephalitis. PLOS ONE, 2015, 10(10): e139974.
10.	Robert SF, Carlos A, Alexis A, et al. A practical clinical definition of epilepsy. Epilepsia, 2014, 55(4): 475-482.
11.	Annegers JF, Hauser WA, Beghi E, et al. The risk of unprovoked seizures after encephalitis and meningitis. Neurology, 1988, 38(9): 1407-1410.
12.	Spatola M, Dalmau J. Seizures and risk of epilepsy in autoimmune and other inflammatory encephalitis. Current Opinion in Neurology, 2017, 30(3): 345-353.
13.	Jorina ME, Ari B, Susan E, et al. A 12-Year prospective study of childhood herpes simplex encephalitis: Is there a broader spectrum of disease? Pediatrics, 2007, 119(2): e399-e407.
14.	Lin J, Hsia S, Wu C, et al. Mycoplasma pneumoniae-related postencephalitic epilepsy in children. Epilepsia, 2011, 52(11): 1979-1985.
15.	Liu X, Yan B, Wang R, et al. Seizure outcomes in patients with anti‐NMDAR encephalitis: A follow‐up study. Epilepsia, 2017, 58(12): 2104-2111.
16.	李静, 张振国, 孙印旗, 等. 细菌性脑炎/脑膜炎 266 例流行病学分析. 预防医学情报杂志, 2012, 28(05): 334-336.
17.	Yao L, Yue W, Xunyi W, et al. Clinical features and long-term outcomes of seizures associated with autoimmune encephalitis: A follow-up study in East China. Journal of Clinical Neuroscience, 2019, 68: 73-79.
18.	Bartolini L, Theodore WH, Jacobson S, et al. Infection with HHV-6 and its role in epilepsy. Epilepsy Research, 2019, 153: 34-39.
19.	Vezzani A, Lang B, Aronica E. Immunity and inflammation in epilepsy. Cold Spring Harbor Perspectives in Medicine, 2016, 6(2): a22699.
20.	van Vliet E A, Aronica E, Vezzani A, et al. Neuroinflammatory pathways as treatment targets and biomarker candidates in epilepsy: emerging evidence from preclinical and clinical studies. Neuropathology and Applied Neurobiology, 2018, 44(1): 91-111.
21.	Vezzani A, Fujinami RS, White HS, et al. Infections, inflammation and epilepsy. Acta Neuropathologica, 2016, 131(2): 211-234.
22.	张伊佳, 秦炯. 免疫炎症因素在癫痫中的作用机制. 中国免疫学杂志, 2019, 35(8): 1024-1026.
23.	Vezzani A, Balosso S, Ravizza T. Neuroinflammatory pathways as treatment targets and biomarkers in epilepsy. Nat Rev Neurol, 2019, 15(8): 459-472.
24.	Misra UK, Tan CT, Kalita J. Viral encephalitis and epilepsy. Epilepsia, 2008, 49(1): 13-18.
25.	Sellner J, Trinka E. Seizures and epilepsy in herpes simplex virus encephalitis: current concepts and future directions of pathogenesis and management. Journal of Neurology, 2012, 259(10): 2019-2030.
26.	Vogrig A. Postencephalitic epilepsy in children andadults: Etiology matters. Epilepsia, 2016, 57(4): 671-672.
27.	Singh TD, Rabinstein AA. In response: Postencephalitic epilepsy inchildren and adults: Etiology matters. Epilepsia, 2016, 57(4): 672-673.
28.	Pillai S, Dale RC. In response: Postencephalitic epilepsy in children and adults: Etiology matters. Epilepsia, 2016, 57(4): 677-678.
29.	Misra UK, Kalita J. Seizures in encephalitis: Predictors and outcome. Seizure, 2009, 18(8): 583-587.
30.	Hosoya M, Ushiku H, Arakawa H, et al. Low-voltage activity in EEG during acute phase of encephalitis predicts unfavorable neurological outcome. Brain & Development, 2002, 24(3): 161-165.
31.	Rismanchi N, Gold JJ, Sattar S, et al. Epilepsy after resolution of presumed childhood encephalitis. Pediatric Neurology, 2015, 53(1): 65-72.
32.	Ko T, Holmes GL. EEG and clinical predictors of medically intractable childhood epilepsy. Clinical Neurophysiology, 1999, 110(7): 1245-1251.
33.	Ellul M, Solomon T. Acute encephalitis-diagnosis and management. Clin Med (Lond), 2018, 18(2): 155-159.
34.	Gunawardane N, Fields M. Acute symptomatic seizures and provoked seizures: to treat or not to treat? Current Treatment Options in Neurology, 2018, 20(10).
35.	Michael BD, Solomon T. Seizures and encephalitis: Clinical features, management, and potential pathophysiologic mechanisms. Epilepsia, 2012, 53(1): 63-71.
36.	Yasiry Z, Shorvon SD. The relative effectiveness of five antiepileptic drugs in treatment of benzodiazepine-resistant convulsive status epilepticus: A meta-analysis of published studies. Seizure, 2014, 23(3): 167-174.
37.	Ramantani G, Holthausen H. Epilepsy after cerebral infection: review of the literature and the potential for surgery. Epileptic Disorders, 2017, 19(2): 117-136.
38.	赵萌, 关宇光, 周健, 等. 迷走神经刺激术治疗儿童脑炎后药物难治性癫痫的疗效分析. 中华实用儿科临床杂志, 2018, 33(23): 1820-1822.
39.	Pitkänen A. Therapeutic approaches to epileptogenesis-Hope on the horizon. Epilepsia, 2010, 51(1): 2-17.
40.	Leng X, Yuan F, Zhao J, et al. Long-term seizure outcome in patients with status epilepticus due to acute encephalitis. Seizure, 2019, 69: 70-75.

1. Rao S, Elkon B, Flett KB, et al. Long-term outcomes and risk factors associated with acute encephalitis in children. Journal of the Pediatric Infectious Diseases Society, 2017, 6(1): 20-27.
2. Fowler A, Stodberg T, Eriksson M, et al. Long-term outcomes of acute encephalitis in childhood. Pediatrics, 2010, 126(4): e828-e835.
3. Lee W, Yu T, Chang W, et al. Risk factors for postencephalitic epilepsy in children: A hospital-based study in Taiwan. European Journal of Paediatric Neurology, 2007, 11(5): 302-309.
4. Chen YJ, Fang PC, Chow JC. Clinical characteristics and prognostic factors of postencephalitic epilepsy in children. J Child Neurol, 2006, 21(12): 1047-1051.
5. Pillai SC, Mohammad SS, Hacohen Y, et al. Postencephalitic epilepsy and drug-resistant epilepsy after infectious and antibody-associated encephalitis in childhood: Clinical and etiologic risk factors. Epilepsia, 2016, 57(1): e7-e11.
6. Singh TD, Fugate JE, Hocker SE, et al. Postencephalitic epilepsy: Clinical characteristics and predictors. Epilepsia, 2015, 56(1): 133-138.
7. Pedersen E. Postencephalitic Epilepsy. Epilepsia, 1964, (5): 43-50.
8. Yoshioka M, Kuroki S, Mizue H. Clinical and electroencephalographic studies of postencephalitic epilepsy. Acta Paediatr Jpn, 1989, 31(4): 480-483.
9. Lin K, Lin J, Hsia S, et al. Effect of antiepileptic drugs for acute and chronic seizures in children with encephalitis. PLOS ONE, 2015, 10(10): e139974.
10. Robert SF, Carlos A, Alexis A, et al. A practical clinical definition of epilepsy. Epilepsia, 2014, 55(4): 475-482.
11. Annegers JF, Hauser WA, Beghi E, et al. The risk of unprovoked seizures after encephalitis and meningitis. Neurology, 1988, 38(9): 1407-1410.
12. Spatola M, Dalmau J. Seizures and risk of epilepsy in autoimmune and other inflammatory encephalitis. Current Opinion in Neurology, 2017, 30(3): 345-353.
13. Jorina ME, Ari B, Susan E, et al. A 12-Year prospective study of childhood herpes simplex encephalitis: Is there a broader spectrum of disease? Pediatrics, 2007, 119(2): e399-e407.
14. Lin J, Hsia S, Wu C, et al. Mycoplasma pneumoniae-related postencephalitic epilepsy in children. Epilepsia, 2011, 52(11): 1979-1985.
15. Liu X, Yan B, Wang R, et al. Seizure outcomes in patients with anti‐NMDAR encephalitis: A follow‐up study. Epilepsia, 2017, 58(12): 2104-2111.
16. 李静, 张振国, 孙印旗, 等. 细菌性脑炎/脑膜炎 266 例流行病学分析. 预防医学情报杂志, 2012, 28(05): 334-336.
17. Yao L, Yue W, Xunyi W, et al. Clinical features and long-term outcomes of seizures associated with autoimmune encephalitis: A follow-up study in East China. Journal of Clinical Neuroscience, 2019, 68: 73-79.
18. Bartolini L, Theodore WH, Jacobson S, et al. Infection with HHV-6 and its role in epilepsy. Epilepsy Research, 2019, 153: 34-39.
19. Vezzani A, Lang B, Aronica E. Immunity and inflammation in epilepsy. Cold Spring Harbor Perspectives in Medicine, 2016, 6(2): a22699.
20. van Vliet E A, Aronica E, Vezzani A, et al. Neuroinflammatory pathways as treatment targets and biomarker candidates in epilepsy: emerging evidence from preclinical and clinical studies. Neuropathology and Applied Neurobiology, 2018, 44(1): 91-111.
21. Vezzani A, Fujinami RS, White HS, et al. Infections, inflammation and epilepsy. Acta Neuropathologica, 2016, 131(2): 211-234.
22. 张伊佳, 秦炯. 免疫炎症因素在癫痫中的作用机制. 中国免疫学杂志, 2019, 35(8): 1024-1026.
23. Vezzani A, Balosso S, Ravizza T. Neuroinflammatory pathways as treatment targets and biomarkers in epilepsy. Nat Rev Neurol, 2019, 15(8): 459-472.
24. Misra UK, Tan CT, Kalita J. Viral encephalitis and epilepsy. Epilepsia, 2008, 49(1): 13-18.
25. Sellner J, Trinka E. Seizures and epilepsy in herpes simplex virus encephalitis: current concepts and future directions of pathogenesis and management. Journal of Neurology, 2012, 259(10): 2019-2030.
26. Vogrig A. Postencephalitic epilepsy in children andadults: Etiology matters. Epilepsia, 2016, 57(4): 671-672.
27. Singh TD, Rabinstein AA. In response: Postencephalitic epilepsy inchildren and adults: Etiology matters. Epilepsia, 2016, 57(4): 672-673.
28. Pillai S, Dale RC. In response: Postencephalitic epilepsy in children and adults: Etiology matters. Epilepsia, 2016, 57(4): 677-678.
29. Misra UK, Kalita J. Seizures in encephalitis: Predictors and outcome. Seizure, 2009, 18(8): 583-587.
30. Hosoya M, Ushiku H, Arakawa H, et al. Low-voltage activity in EEG during acute phase of encephalitis predicts unfavorable neurological outcome. Brain & Development, 2002, 24(3): 161-165.
31. Rismanchi N, Gold JJ, Sattar S, et al. Epilepsy after resolution of presumed childhood encephalitis. Pediatric Neurology, 2015, 53(1): 65-72.
32. Ko T, Holmes GL. EEG and clinical predictors of medically intractable childhood epilepsy. Clinical Neurophysiology, 1999, 110(7): 1245-1251.
33. Ellul M, Solomon T. Acute encephalitis-diagnosis and management. Clin Med (Lond), 2018, 18(2): 155-159.
34. Gunawardane N, Fields M. Acute symptomatic seizures and provoked seizures: to treat or not to treat? Current Treatment Options in Neurology, 2018, 20(10).
35. Michael BD, Solomon T. Seizures and encephalitis: Clinical features, management, and potential pathophysiologic mechanisms. Epilepsia, 2012, 53(1): 63-71.
36. Yasiry Z, Shorvon SD. The relative effectiveness of five antiepileptic drugs in treatment of benzodiazepine-resistant convulsive status epilepticus: A meta-analysis of published studies. Seizure, 2014, 23(3): 167-174.
37. Ramantani G, Holthausen H. Epilepsy after cerebral infection: review of the literature and the potential for surgery. Epileptic Disorders, 2017, 19(2): 117-136.
38. 赵萌, 关宇光, 周健, 等. 迷走神经刺激术治疗儿童脑炎后药物难治性癫痫的疗效分析. 中华实用儿科临床杂志, 2018, 33(23): 1820-1822.
39. Pitkänen A. Therapeutic approaches to epileptogenesis-Hope on the horizon. Epilepsia, 2010, 51(1): 2-17.
40. Leng X, Yuan F, Zhao J, et al. Long-term seizure outcome in patients with status epilepticus due to acute encephalitis. Seizure, 2019, 69: 70-75.

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Journal of Epilepsy

脑炎后癫痫诊断与治疗进展

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