Response to antiseizure medications in epileptic patients with malformation of cortical development.
Response to antiseizure medications in epileptic patients with malformation of cortical development.
复制标题
DOI：
10.1177/17562864211050027
复制
发表时间：
2021
影响因子：
5.9
通讯作者：
Wang S
中科院分区：
文献类型：
--
作者：
Chen W;Jin B;Aung T;He C;Chen C;Wang S;Ding Y;Ding F;Wang C;Li H;Jiang B;Zheng Z;Dai H;Zhu J;Geng Y;Ding M;Wang S
皮质发育畸形（MCD）是耐药性癫痫最常见的原因之一。提高MCD癫痫患者抗癫痫药物（ASMs）治疗反应的知识对于最佳治疗选择（药物治疗或非药物干预）至关重要。目的：探讨应用ASM方案治疗MCD所致癫痫的药物治疗结局模式和无癫痫发作（SF）的预测因素。MCD癫痫患者于2013年3月至2019年6月连续入组。SF定义为至少12个月无癫痫发作或最长治疗前癫痫发作间期的3倍，以较长者为准。结果分为三种模式：模式A：患者在一个时间点达到SF，并在整个随访期间保持SF;模式B：患者的癫痫发作在SF和复发之间波动;模式C：从未达到SF。如果患者在末次随访访视时仍为SF，则定义为终末SF。共纳入164例患有MCD的癫痫患者。A型22例，B型42例，C型100例。64例（A型和B型）患者曾达到SF。中位随访时间为4.3年后，29例患者出现终末SF。在持续ASM治疗的情况下，5年无癫痫发作期后癫痫发作复发风险非常低。治疗前癫痫发作频率是A型和癫痫复发的唯一独立预测因子。在初始ASM方案中，钠通道阻滞剂单药治疗（33.8%）在使SF发生方面比左乙拉西坦（4.5%）更有效。少数MCD癫痫患者的药物治疗可以取得成功，治疗前癫痫发作频率有助于预测治疗结果。ASM在MCD引起的癫痫中的疗效不一，表明病因学评价在局灶性癫痫的管理中至关重要。
Malformation of cortical development (MCD) is one of the most common causes of pharmacoresistant epilepsy. Improving the knowledge of antiseizure medications (ASMs) treatment response in epileptic patients with MCD is crucial for optimal treatment options, either pharmacological therapy or non-pharmacological intervention. To investigate the patterns of medical treatment outcome and the predictors for seizure freedom (SF) with ASM regimens in epilepsy caused by MCD. The epileptic patients with MCD were consecutively enrolled from March 2013 to June 2019. SF was defined as no seizures for at least 12 months or three times the longest pretreatment inter-seizure interval, whichever was longer. Outcomes were classified into three patterns: pattern A: patients achieved SF at one point and remained so throughout follow-up; pattern B: patients’ seizures fluctuated between periods of SF and relapse; pattern C: SF never attained. The terminal SF was defined if the patients remained SF at the last follow-up visit. A total of 164 epileptic patients with MCD were included. Pattern A was observed in 22, pattern B in 42, and pattern C in 100 patients. SF was ever achieved in 64 (pattern A and B) patients. Twenty-nine patients had terminal SF after a median follow-up time of 4.3 years. With continuing ASM treatment, seizure relapse risk was very low after a 5-year seizure-free period. The pretreatment seizure frequency was the only independent predictor for pattern A and seizure relapse. Sodium channel blockers monotherapy (33.8%) was more effective than levetiracetam (4.5%) in rendering SF in the initial ASM regimen. Medical treatment can be successful in a minority of epileptic patients with MCD, and pretreatment seizure frequency helps to predict the treatment outcome. An unequal efficacy of ASMs in epilepsy caused by MCD suggests etiological evaluation is vital in the management of focal epilepsy.
登录
查看更多内容
利用基于表面的磁共振成像后处理和机器学习自动检测 II 型局灶性皮质发育不良
影响因子：
5.6
作者：
Jin B;Krishnan B;Adler S;Wagstyl K;Hu W;Jones S;Najm I;Alexopoulos A;Zhang K;Zhang J;Ding M;Wang S;Pediatric Imaging, Neurocognition, and Genetics Study;Wang ZI
通讯作者：
Wang ZI
影响因子：
2.2
作者：
Maynard, Lauren M.;Leach, James L.;Greiner, Hansel M.
通讯作者：
Greiner, Hansel M.
影响因子：
6
作者：
Abou-Khalil, Bassel
通讯作者：
Abou-Khalil, Bassel
DOI：
10.1093/brain/aws019
发表时间：
2012-05
期刊：
Brain : a journal of neurology
影响因子：
--
作者：
Barkovich AJ;Guerrini R;Kuzniecky RI;Jackson GD;Dobyns WB
通讯作者：
Dobyns WB
影响因子：
14.5
作者：
O'Donoghue, MF;Duncan, JS;Sander, JWAS
通讯作者：
Sander, JWAS