中文摘要：

目的分析中老年复杂部分性发作癫痫持续状态（CPSE）的临床特点及误诊原因。方法收集广州医学院第二附属医院神经内科自2008年1月至12月收治、曾被外院误诊的中老年CPSE患者的临床资料，进行视频脑电图（EEG）、头颅MR、生化检查，根据国际抗癫痫联盟的CPSE诊断标准进行诊断，并随访3个月以上。结果本组患者7例，均为女性，其中额叶癫痫（FLE）2例，颞叶癫痫（TLE）5例；CPSE患者临床症状和视频EEG表现多样化；经抗癫痫药物（AEDs）治疗后3例至少3个月无发作，3例仍有CPSE发作，1例仍有反复CPSE。结论由于CPSE患者临床症状和EEG表现欠典型，常合并其他系统疾病和社会因素的影响易被误诊，应及早做视频EEG检查以明确诊断；口服AEDs治疗可取得良好效果。

英文摘要：

Objective To investigate the clinical features and causes ofmisdiagnosis of complex partial status epilepticus （CPSE） in the elderly. Methods The clinical data of elderly patients with CPSE admitted in our department between January and December, 2008 with previous misdiagnosis were reviewed. The diagnosis of CPSE was established according to the diagnostic criteria of the International League Against Epilepsy （ILAE）. All the patients underwent video-EEG examination, head magnetic resonance imaging （MR/）, and routine biochemical examination, and were followed up for at least 3 months. Results Seven female CPSE patients were involved in this analysis including 2 with frontal lobe epilepsy and 5 with temporal lobe epilepsy. The conditions were misdiagnosed as a variety of diseases including Alzheimer＇s disease, cerebral infarction, coronary heart disease, encephalitis, hysterism, and schizophrenia, and the duration of the misdiagnoses ranged from 2 days to 40 years. Video-EEG showed slow background, continuous interictal discharges or high-voltage slow waves in the temporal or frontal lobe, or ictal discharges of complex partial seizures. After treatment with antiepileptic medications, 3 patients were flee of epileptic episodes within 3 months, 3 still remained in complex partial status, and 1 had repeated CPSE. Conclusions Complex symptoms, atypical EEG, co-morbidity and social factors all contribute to misdiagnosis of CPSE in the elderly. Suspected patients should undergo video-EEG examination for a definite diagnosis as early as possible.