Childhood absence epilepsy: Evolution and prognostic factors
Childhood absence epilepsy: Evolution and prognostic factors
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DOI：
10.1111/j.1528-1167.2005.00277.x
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发表时间：
2005-11-01
期刊：
影响因子：
5.6
通讯作者：
Balestri, P
中科院分区：
文献类型：
--
作者：
Grosso, S;Galimberti, D;Balestri, P
目的：评估诊断标准如何影响儿童失神癫痫(CAE)患者的缓解率，并评估临床和脑电参数作为预测预后的指标。方法：根据国际抗癫痫联盟(ILAE)的分类标准，119例CAE患者被诊断为CAE。随后，根据更严格的诊断标准对它们进行了评估。符合上述标准的62名受试者为第2组；结果：与第1组相比，第2组的癫痫控制率(95%比77%)更高，最终缓解率(82%比51%)更高，全身强直阵挛发作更少(8%比30%)，平均疗程更短(2.2%比3.8年)。第二组接受综合治疗的患者明显少于第一组(11%比47%)，在停药时癫痫复发的患者也较少(0比22%)。结论：CAE患者的缓解率受选择的分类标准的影响很大。更严格的诊断标准允许定义一组预后良好的同质患者。预测预后不良的因素有失神活动期全身强直阵挛发作、肌阵挛、眼睑肌阵挛或口周肌阵挛，CAE的脑电特征不典型。
Purpose: To evaluate how diagnostic criteria influence remission rates for patients with childhood absence epilepsy (CAE) and to assess clinical and EEG parameters as predictors of outcome.Methods: One hundred nineteen patients were diagnosed with CAE, according to International League Against Epilepsy (ILAE) classification criteria. They were subsequently evaluated according to stricter diagnostic criteria. Sixty-two subjects fulfilled these criteria as group 2; 57 did not and constituted group 1. Diagnostic parameters that prevented patients of group 1 from entering group 2, and variables such as sex, familial history of generalized epilepsy, and personal history of febrile convulsions also were tested as prognostic factors for terminal remission.Results: Compared with those in group 1, patients of group 2 had significantly higher rates of seizure control (95% vs. 77%), higher rates of terminal remission (82% vs. 51%), fewer generalized tonic-clonic seizures (8% vs. 30%), and shorter mean periods of treatment (2.2 vs. 3.8 years). Significantly fewer patients were receiving polytherapy in group 2 than in group 1 (11% vs. 47%), and fewer patients had seizure relapses at antiepileptic drug discontinuation (0 vs. 22%).Conclusions: Remission rates of patients with CAE are greatly influenced by the classification criteria used for selection. Stricter diagnostic criteria allow the definition of a homogeneous group of patients with excellent prognosis. Factors predicting unfavorable prognosis were generalized tonic-clonic seizures in the active stage of absences, myoclonic jerks, eyelid myoclonia or perioral myoclonia, and EEG features atypical for CAE.