THE PROGNOSIS FOR SEIZURE CONTROL IN NEWLY DIAGNOSED EPILEPSY
THE PROGNOSIS FOR SEIZURE CONTROL IN NEWLY DIAGNOSED EPILEPSY
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DOI：
10.1056/nejm198410113111503
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发表时间：
1984-01-01
影响因子：
158.5
通讯作者：
REYNOLDS, EH
中科院分区：
文献类型：
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作者：
ELWES, RDC;JOHNSON, AL;REYNOLDS, EH
对106例有强直-阵挛发作、部分性发作或混合性发作的成人神经科门诊患者的癫痫控制预后进行了评估，并前瞻性地随访了中位数为66个月。(范围，6-96)。26名患者在随访期间完全没有癫痫发作。精算分析显示，35%的患者有望在治疗开始时进入至少2年的无癫痫期，73%的患者在4年结束时将有2年的无癫痫期，82%的患者在8年结束时有2年的无癫痫期。在79名癫痫发作被完全控制至少2年的患者中，51名患者随后仍无癫痫发作。如果癫痫发作在治疗开始后持续长达2年，随后癫痫发作控制的可能性下降了一半。以下情况表明预后更差。部分癫痫的存在；治疗前强直-阵挛发作的频率很高；有神经、社会或精神障碍，以及癫痫家族史。长期的癫痫控制模式主要是在治疗的头两年期间建立的。
The prognosis for seizure control in 106 patients was assessed who were referred to an adult neurology clinic with previously untreated tonic-clonic, partial or mixed seizures was assessed and followed prospectively for a median of 66 mo. (range, 6-96). Twenty-six patients remained completely seizure-free for as long as they were followed. Actuarial analysis showed that 35% of patients could be expected to enter a seizure-free period of at least 2 yr at the start of treatment, 73% would have had a 2-yr seizure-free period at the end of 4 yr, and 82% would have had a 2-yr seizure-free period at the end of 8 yr. Of 79 patients whose seizures were completely controlled for at least 2 yr, 51 subsequently remained seizure-free. If seizures continued for up to 2 yr after the start of treatment, the probability of subsequent seizure control fell by half. The following indicated a worse prognosis. The presence of partial seizures; a high frequency of tonic-clonic seizures before treatment; a neurologic, social or psychiatric handicap and a family history of epilepsy. The long-term seizure control pattern is largely established during the first 2 yr of treatment.