소아 지속 발작의 임상 특성
Clinical Characteristics of Prolonged Seizure in Children
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목적: 5분 이상의 지속발작은 뇌 신경손상으로 이어지는 연속적인발작으로 진행될 수 있기 때문에 발작이 지속되지 않게 빨리 치료되어야 한다. 이에 저자들은 지속발작과 연관된 임상 양상을 분석하기위해 본 연구를 진행하였다. 방법: 2012년 1월부터 12월까지 30분 이하의 첫 발작을 주소로 원주세브란스기독병원에 내원한 환아 192명을 대상으로 하였다. 발작시간 5분을 기준으로 5분 미만인 group A, 5분 이상인 group B로나누어 성별, 나이, 과거력, 가족력, 발작유형, 영상검사, 뇌파검사, 혈액검사 등의 임상 양상을 비교하였고, 약 2년간의 추적 기간 동안 발작의 재발 및 뇌전증의 진단 유무를 비교하였다. 결과: group A는 110명, group B는 82명이었다. 칼륨 수치를 제외하고, 두 군에서 임상양상의 통계학적 차이는 없었다. 혈청 칼륨은group A에서 4.46±0.49 mmol/L, group B에서는 4.30±0.45 mmol/L 으로 유의미하게 차이가 있었다(P=0.0338). 발작의 재발은group A에서 27.1%, group B에서는 36.4% 발생했고, 이중 group A 에서는 13.1%, group B에서는 18.2%가 뇌전증으로 진행되었다(P=0.3819). 결론: 저자들은 지속발작 환아의 임상양상 중에 혈청 칼륨이 낮은것을 제외하고는 통계적인 의의를 찾을 수 없었으나, 추적관찰에서 5 분 이상의 지속 발작이 있었던 환아에서 발작의 재발 및 뇌전증 진단이 더 많은 경향을 볼 수 있어서 가능한 발작 후 5분 이내에 발작의조절이 필요할 것으로 사료되었다.
Abstract
Purpose: Prolonged seizure, defined as seizures lasting more than 5 minutes, should be treated to prevent continuous seizures that cause brain injuries. In this paper, we will evaluate the clinical characteristics of prolonged seizures in children. Methods: Between the January and the December of 2012, 192 patients were admitted to Wonju Severance Christian Hospital due to epileptic seizures lasting less than 30 minutes. They were divided into two groups according to the duration of their seizures: less than 5 minutes (Group A), and between 5 and 30 minutes (Group B). We compared the clinical characteristics such as sex, onset age, family history, seizure types, cause, imaging studies, electroencephalography, laboratory findings, and prognosis between the two groups. Results: Group A consisted of 110 patients; group B consisted of 82. With the exception of serum potassium level, no statistically significant differences in clinical characteristics between the two groups were observed. Serum potassium level of the laboratory test was 4.46±0.49 in group A, and 4.30±0.45 in group B (P=0.0338). The rate of further seizure episodes was 27.1% in group A and 36.4% in group B. Among them, 13.1% of group A and 18.2% of group B were later diagnosed with epilepsy (P=0.3819). Conclusion: There were no statistically significant differences in the clinical characteristics between the two groups except for the serum potassium level; however, patients whose seizures lasted longer than 5 minutes tended to experience further seizure episodes and were more likely to be diagnosed with epilepsy.
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