EEG AND OTHER EARLY PREDICTORS OF EPILEPSY REMISSION - A COMMUNITY STUDY
EEG AND OTHER EARLY PREDICTORS OF EPILEPSY REMISSION - A COMMUNITY STUDY
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DOI：
10.1111/j.1528-1157.1988.tb03767.x
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发表时间：
1988-09-01
期刊：
影响因子：
5.6
通讯作者：
KLASS, DW
中科院分区：
文献类型：
--
作者：
SHAFER, SQ;HAUSER, WA;KLASS, DW
回顾了美国明尼苏达州罗切斯特市所有306名居民的癫痫发作过程，这些居民在1935年至1978年期间被诊断为癫痫，诊断后5年居住在该地区，并有脑电图(EEG)。确诊后20年内达到无癫痫发作(FYSF)的寿命表概率为75%。在多变量比例风险模型中，这三个变量预测达到FYSF的比率显著更高：没有早期脑损伤(缓解率比=2.27，p<；0.01)，没有全身性癫痫样活动(缓解率比=1.58，p<；0.05)，以及从未发生全面性强直-阵挛发作(率比=1.4，p<；0.05)。同样的三个变量，加上确诊时的年龄，是描述停药后达到FYSF的比率的指标。性别、家族史、癫痫发作类型和除全身性癫痫样活动外的脑电结果与两个终点均无显著相关。预测因子集合在预测FYSF中的概率比先前的概率高出15%。尽管这些预测因子提供了有关群体经验的信息，但无论是单独的还是在一组中，这些预测因子都是弱的临床鉴别因子。即使那些病史、临床检查或EEG结果将他们置于一个或多个预测因素中不太有利的一层的人，FYSF的发生比例也很高。
The course of seizures was reviewed in all 306 residents of Rochester, Minnesota [USA] who had epilepsy diagnosed between 1935 and 1978, lived in the region .gtoreq.5 years after diagnosis, and had an electroencephalogram (EEG). The life-table probability of having achieved a years seizure-free (FYSF) by 20 years after diagnosis was 75%. In a multivariable proportional hazards model, these three variables predicted a significantly higher rate of achieving FYSF: no early-life brain damage (remission rate ratio=2.27, p < 0.01), no generalized epileptiform activity (rate ratio=1.58, p < 0.05), and never having had a generalized tonic-clonic seizure (rate ratio=1.4, p < 0.05). The same three variables, plus age at diagnosis, were descriptors of the rate of reaching FYSF off medication. Gender, family history, type of seizure, and EEG findings other than generalized epileptiform activity were not significantly related to either end point. The predictor set did 15% between than prior probabilties in forecasting FYSF. Although informative about group experience, these predictors are weak clinical discriminators, singly or in a set. FYSF occurred in high proportion of even those persons whose history, clinical examination, or EEG findings placed them in a less favorable stratum of one or more predictors.