Remission and relapse in a drug-resistant epilepsy population followed prospectively.
Remission and relapse in a drug-resistant epilepsy population followed prospectively.
复制标题
DOI：
10.1111/j.1528-1167.2010.02929.x
复制
发表时间：
2011-03
期刊：
影响因子：
5.6
通讯作者：
French J
中科院分区：
文献类型：
--
作者：
Callaghan B;Schlesinger M;Rodemer W;Pollard J;Hesdorffer D;Allen Hauser W;French J
我们调查了一个患有耐药性癫痫和频繁癫痫发作的成年人群中癫痫发作缓解和复发的累积概率。此外，我们确定了该人群缓解和复发的临床预测因素。2003年，我们在一个中心发现了246名耐药癫痫患者，耐药癫痫定义为每月至少一次癫痫发作并且至少两种抗癫痫药物治疗失败。前瞻性随访这些患者（队列设计）。我们使用Kaplan-Meier方法研究了这一人群中癫痫缓解和复发的累积概率。还使用考克斯回归分析评估了缓解和复发的临床预测因素。在整个人群中，7年时12个月癫痫缓解的估计累积概率为34.6%，仅限于未手术患者时为33.4%。癫痫发作缓解12个月后复发的风险在5年时为71.2%。癫痫缓解的阴性预测因子包括发育迟缓、症状性全身性癫痫综合征、难治性持续时间和抗癫痫药物治疗失败的次数。局部相关癫痫是复发的唯一阴性预测因子。在耐药性癫痫患者中，即使随访6年，每年仍有5%的患者癫痫发作缓解。然而，这些患者中有相当一部分在缓解后的第一年后复发。进入显著缓解的患者比例很大，这给这些患者带来了希望;但是，在讨论未来癫痫发作的可能性时，应谨慎。
We investigated the cumulative probability of seizure remission and relapse in an adult population with drug-resistant epilepsy and frequent seizures. In addition, we determined clinical predictors of remission and relapse in this population. In 2003, we identified 246 patients at a single center with drug-resistant epilepsy defined as at least one seizure per month and failure of at least two antiepileptic drugs. These patients were followed prospectively (cohort design). We examined the cumulative probability of seizure remission and relapse in this population using Kaplan- Meier methodology. Clinical predictors of remission and relapse were also evaluated using Cox regression analysis. The estimated cumulative probability of 12-month seizure remission was 34.6% at 7 years in the entire population and 33.4% when limited to those without surgery. The risk for relapse after a 12-month period of seizure remission was 71.2% at 5 years. Negative predictors of seizure remission included developmental delay, symptomatic generalized epilepsy syndrome, duration of intractability, and number of antiepileptic drugs failed. Localization-related epilepsy was the only negative predictor of relapse. Among patients with drug-resistant epilepsy, 5% per year enter seizure remission even with a follow-up of 6 years. However, a substantial proportion of these patients relapse after the first year following a remission. The large proportion of patients entering a significant remission gives these patients hope; however, caution should be advised when discussing the likelihood of future seizures.
登录
查看更多内容
影响因子：
158.5
作者：
ELWES, RDC;JOHNSON, AL;REYNOLDS, EH
通讯作者：
REYNOLDS, EH
影响因子：
11.2
作者：
Callaghan, Brian C.;Anand, Kishlay;French, Jacqueline A.
通讯作者：
French, Jacqueline A.
影响因子：
5.6
作者：
SILLANPAA, M
通讯作者：
SILLANPAA, M
影响因子：
5.6
作者：
SHAFER, SQ;HAUSER, WA;KLASS, DW
通讯作者：
KLASS, DW
影响因子：
5.6
作者：
Kwan, Patrick;Arzimanoglou, Alexis;French, Jacqueline
通讯作者：
French, Jacqueline