Epileptic auras and their role in driving safety in people with epilepsy.
Epileptic auras and their role in driving safety in people with epilepsy.
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DOI：
10.1111/epi.13189
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发表时间：
2015-11
期刊：
影响因子：
5.6
通讯作者：
Blumenfeld H
中科院分区：
文献类型：
--
作者：
Punia V;Farooque P;Chen W;Hirsch LJ;Berg AT;Multicenter Study of Epilepsy Surgery;Blumenfeld H
本研究的目的是评估先兆在预防药物难治性癫痫患者机动车事故（MVA）中的作用。癫痫手术多中心研究数据库用于进行病例对照研究，确定在驾驶时癫痫发作导致MVA的患者（病例）和在驾驶时癫痫发作而无MVA的患者（对照）。我们比较了两组之间可靠的先兆和其他先兆相关特征的存在。553例患者中有215例报告在驾驶时癫痫发作; 74例被确定为“对照”，141例被确定为“病例”。两组患者具有相似的人口统计学和临床特征。两组之间可靠先兆的存在没有差异（病例组为67%，对照组为65%; OR = 0.89，95%CI 0.49 - 1.61，p = 0.76）。此外，两组报告先兆较长（>1分钟）的患者比例（OR 0.7; 95% CI 0.28 - 1.76; p = 0.47）或认为其先兆足够长以保护自己的患者比例（OR 1.19; 95% CI 0.62 - 2.00; p = 0.77）无差异。我们的研究质疑了长期以来的信念，即可靠的先兆对癫痫患者的MVA具有保护作用。
The aim of our study was to evaluate the role of auras in preventing motor vehicle accidents (MVA) among medically-refractory epilepsy patients. The Multicenter Study of Epilepsy Surgery database was used to perform a case-control study by identifying patients who had seizures while driving that led to MVAs (Cases) and those who had seizures while driving without MVAs (Controls). We compared presence of reliable auras and other aura-related features between the two groups. 215 out of 553 patients reported having seizure(s) while driving; 74 were identified as ‘Controls’ and 141 as ‘Cases’. The two groups had similar demographic and clinical features. The presence of reliable auras was not different between the two groups (67% in Cases vs 65% in Controls; OR = 0.89, 95% CI 0.49 – 1.61, p = 0.76). In addition, the groups did not differ in the proportion of patients who reported longer (>1 minute) auras (OR 0.7; 95% CI 0.28 – 1.76; p = 0.47), or who thought that their auras were sufficiently long to protect themselves (OR 1.19; 95% CI 0.62 – 2.00; p = 0.77). Our study questions the long-held belief of a protective role of reliable auras against MVAs in people with epilepsy.