PROGNOSTIC FACTORS FOR SEIZURE RECURRENCE AFTER WITHDRAWAL OF ANTIEPILEPTIC DRUGS IN PATIENTS WITH NEUROCYSTICERCOSIS
PROGNOSTIC FACTORS FOR SEIZURE RECURRENCE AFTER WITHDRAWAL OF ANTIEPILEPTIC DRUGS IN PATIENTS WITH NEUROCYSTICERCOSIS
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DOI：
10.1212/wnl.44.9.1706
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发表时间：
1994-09-01
期刊：
影响因子：
9.9
通讯作者：
DELBRUTTO, OH
中科院分区：
文献类型：
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作者：
DELBRUTTO, OH
我们逐渐减少抗癫痫药物治疗40例因脑囊虫病癫痫发作的患者，他们已经2年没有癫痫发作了。所有患者均接受过阿苯达唑治疗，导致脑囊肿完全破坏。我们对患者进行了前瞻性随访，从诊断开始，直到抗癫痫药物停药后12个月。我们评估了以下癫痫复发的预后因素：性别、控制前癫痫发作次数、癫痫发作类型、阿苯达唑治疗前脑实质囊肿数量、阿苯达唑治疗后EEG表现和CT表现。在癫痫复发预后因素的单变量分析中，阿苯达唑引起的脑钙化的发展是与复发率显著较高相关的唯一因素（p = 0.004）。多因素分析显示，复发性癫痫发作和多发性脑囊肿患者的复发风险也高于单次癫痫发作或单次囊肿患者（p = 0.05）。这项研究表明，由于脑囊虫病癫痫的预后并不像以前认为的那样良性。阿苯达唑治疗前有残余钙化和反复发作及多发囊肿的患者，停药后复发率最高。
We tapered antiepileptic drugs in 40 patients with epilepsy due to neurocysticercosis who had been free of seizures for 2 years. All patients previously received a course of albendazole that resulted in complete destruction of brain cysts. We followed the patients prospectively from the time of diagnosis until 12 months after antiepileptic drug withdrawal. We evaluated the following prognostic factors for seizure recurrence: sex, number of seizures before control, type of seizures, number of parenchymal brain cysts before albendazole therapy, EEG findings, and CT findings after albendazole therapy. In the univariate analysis of prognostic factors for seizure recurrence, the development of brain calcifications caused by albendazole was the only factor associated with a significantly higher rate of relapse (p = 0.004). The multivariate analysis showed that patients who had both recurrent seizures and multiple brain cysts also had a higher risk of relapse than those with single seizures or single cysts (p = 0.05). This study suggests that the prognosis of epilepsy due to neurocysticercosis is not as benign as previously thought. Patients with residual calcifications and those with both recurrent seizures and multiple cysts before albendazole therapy have the highest rate of relapse after withdrawal of antiepileptic drugs.