Seizure disorder

癫痫发作障碍
  • 文章类型: Journal Article
    UNASSIGNED: To study the association of seizure disorder with adverse obstetric outcome in terms of maternal and perinatal complications.
    UNASSIGNED: This longitudinal study was conducted at Maulana Azad Medical College, New Delhi over 15 months among women attending the antenatal clinic (ANC) outpatient department. Fifty pregnant women with seizure disorder with their first ANC visit before 28 weeks were recruited as the case group, excluding patients with eclampsia. The control group included 120 matched healthy pregnant women. After obtaining informed consent, subjects were recruited and followed till one week postpartum and obstetric outcomes were analyzed.
    UNASSIGNED: Women with seizure disorder had significantly increased incidence of severe preeclampsia (cases =8%, controls =0%, p<0.001), antepartum hemorrhage (cases =4%, controls =0%, p<0.001), babies with early neonatal complications such as asphyxia (cases =4.1%, controls =0.5%, p=0.04), respiratory distress (cases =14.5%, controls =5.1%, p=0.02), necrotizing enterocolitis (cases =2.0%, controls =0%, p=0.04), early neonatal death (cases =2.0%, controls =0%, p=0.04) and Neonatal Intensive Care Unit admission (cases =20.8%, controls =8.6%, p<0.001) when compared with women without seizure disorder. No significant difference was observed in rates of induction of labor, cesarean section, abortion, congenital anomalies in babies, still births. Conclusion: Women with seizure disorder are at higher risk of hypertensive disorders, antepartum hemorrhage, and early neonatal complications.
    UNASSIGNED: Women with seizure disorder are at higher risk of hypertensive disorders, antepartum hemorrhage, and early neonatal complications. Appropriate obstetric, pediatric and neurology care is required during preconception, pregnancy, labor, delivery, and postpartum.
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  • 文章类型: Journal Article
    背景:麻疹(rubeola)是一种高度传染性的传染病,具有显著的发病率/死亡率。麻疹-腮腺炎-风疹(MMR)是一种在美国(US)用于预防麻疹的减毒活疫苗。这项回顾性纵向队列研究评估了儿童MMR疫苗接种以及癫痫发作和癫痫发作的风险。
    方法:使用SAS分析了由佛罗里达医疗补助计划前瞻性生成的记录组成的独立医疗保健研究数据库(IHRD),以识别从出生持续120个月的人员。对两组进行了检查:23,486人在12至17个月之间接受了至少一剂MMR疫苗(已接种疫苗),41,725人未接受含麻疹疫苗(未接种疫苗)。初始癫痫发作(ICD-9代码:780.3x)和癫痫发作(ICD-9代码:345)的每日发病率。xx)在初次癫痫发作后,使用Cox比例风险比(HR)和MMR疫苗接种后的时间趋势模型与未接种疫苗的人以及自我对照病例系列(SCCS)进行了检查。
    结果:在HR模型中,与未接种疫苗的人相比,在MMR疫苗接种后6至11天诊断出的初始癫痫发作的每日发病率在12至17个月之间显着增加(未调整的HR=5.73,p<0.0001和调整的HR=5.94,p<0.0001)。在MMR疫苗接种后6至11天被诊断为初次癫痫发作的患者中,最终癫痫发作诊断的每日发病率显着增加(未调整的HR=17.7,p<0.01和调整的HR=17.4,p<0.01)。时间趋势分析显示,初次癫痫发作(RR=4.64,p<0.0001)和癫痫发作(RR=5.51,p<0.0001)的发生率(RR)显着增加。时间趋势SCCS分析显示,当比较MMR疫苗接种后6至11天至MMR疫苗接种后49-60天时,初始癫痫发作的每日发病率显着增加(RR=3.80,p<0.0001)。与MMR疫苗接种后49-60天相比,在MMR疫苗接种后6-11天首次癫痫发作的患者中,最终癫痫发作诊断的发生率显着增加(RR=4.15,p<0.01)。
    结论:癫痫发作和癫痫发作障碍是儿童常规MMR疫苗接种的罕见后果。
    BACKGROUND: Measles (rubeola) is a highly contagious infectious disease with significant morbidity/mortality. Measles-Mumps-Rubella (MMR) is a live-attenuated vaccine used in the United States (US) to prevent measles. This retrospective longitudinal cohort study evaluated childhood MMR vaccination and the risk of a seizure episode and seizure disorder.
    METHODS: The Independent Healthcare Research Database (IHRD) composed of records prospectively generated from Florida Medicaid was analyzed using SAS to identify persons continuously enrolled from birth for 120 months. Two cohorts were examined: 23,486 persons received at least one dose of MMR vaccine between 12 and 17 months (vaccinated) and 41,725 persons not receiving a measles-containing vaccine (unvaccinated). The daily incidence rate of an initial seizure episode (ICD-9 code: 780.3x) and seizure disorder (ICD-9 code: 345.xx) following an initial seizure episode diagnoses were examined using Cox proportional hazards ratio (HR) and time-trend models post-MMR vaccination compared to unvaccinated persons and in a self-controlled case-series (SCCS).
    RESULTS: The daily incidence rate of an initial seizure episode diagnosed from 6 to 11 days post-MMR vaccination in comparison to 12 to17 months among unvaccinated persons was significantly increased (unadjusted HR = 5.73, p < 0.0001 and adjusted HR = 5.94, p < 0.0001) in HR models. The daily incidence rate of an eventual seizure disorder diagnosis among those diagnosed with an initial seizure episode from 6 to 11 days post-MMR vaccination was significantly increased (unadjusted HR = 17.7, p < 0.01 and adjusted HR = 17.4, p < 0.01) in comparison to the daily incidence rate of an eventual seizure disorder diagnosis among those diagnosed with an initial seizure episode from 12 to 17 months among unvaccinated persons. Time-trend analyses revealed a significantly increased rate ratio (RR) for an initial seizure episode (RR = 4.64, p < 0.0001) and seizure disorder (RR = 5.51, p < 0.0001) diagnoses. Time-trend SCCS analyses revealed a significantly increased daily incidence rate of an initial seizure episode (RR = 3.80, p < 0.0001) when comparing periods from 6 to 11 days post-MMR vaccination to 49-60 days post-MMR vaccination. The incidence rate of an eventual seizure disorder diagnosis among those with an initial seizure episode diagnosis from 6 to 11 days post-MMR vaccination compared to 49-60 days post-MMR vaccination was significantly increased (RR = 4.15, p < 0.01).
    CONCLUSIONS: Seizure episode and seizure disorder are rare consequences of routine childhood MMR vaccination.
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  • 文章类型: Journal Article
    Previous research has demonstrated that patients with a history of organophosphate poisoning tend to have a higher risk of neurological disorder. However, research on the rate of seizure development in patients after organophosphate poisoning is lacking. This study examined whether individuals with organophosphate poisoning have an increased risk of seizures through several years of follow-up.
    We conducted a retrospective study on a cohort of 45,060 individuals (9012 patients with a history of organophosphate poisoning and 36,048 controls) selected from the Taiwan National Health Insurance Research Database. The individuals were observed for a maximum of 12 years to determine the rate of new-onset seizure disorder. We selected a comparison cohort from the general population that was randomly frequency-matched by age, sex, and index year and further analyzed the risk of seizures using a Cox regression model adjusted for sex, age, and comorbidities.
    During the study period, the risk of seizure development was 3.57 times greater in patients with organophosphate poisoning compared with individuals without, after adjustments for age, sex, and comorbidities. The absolute incidence of seizures was highest in individuals aged 20 to 34 years in both cohorts (adjusted hazard ratio = 13.0, 95% confidence interval = 5.40-31.4). A significantly higher seizure risk was also observed in patients with organophosphate poisoning and comorbidities other than cirrhosis.
    This nationwide retrospective cohort study demonstrates that seizure risk is significantly increased in patients with organophosphate poisoning compared with the general population.
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