【摘要】 目的:总结分析儿童癫痫发作的远期转归,探讨影响患儿发作控制情况的相关因素。方法:回顾性分析2003年1月至2006年12月在北京大学第一医院儿科神经特需门诊就诊,且随访超过1年的265例癫痫患儿的临床资料,分析患儿发作控制情况,以至少1年无临床复发为标准,计算无发作率。探讨患儿起病年龄、癫痫综合征及病因类型与预后的可能关系。结果:(1)所有病例均明确了发作类型,其中17例为混合发作,明确各种癫痫综合征诊断者163/265例,占61.5%。(2)发作完全控制142/265例,无发作率53.6%。(3)发作控制不满意(无效)组患儿起病年龄(1.90±2.51)岁,明显小于有效组[(4.01±4.74)岁]及无发作组[(4.45±2.87)岁,P<0.01]。(4)无发作率在不同综合征之间差异有统计学意义(P<0.001),特发性全面性癫痫和儿童良性癫痫伴中央颞区棘波的无发作率较高(分别为72.4%和65.5%),婴儿痉挛的无发作率最低(21.7%)。(5)不同病因类型的无发作率也有显著差异,特发性癫痫组的无发作率(69.2%)高于非特发性癫痫组(45.4%,P<0.01)。结论:儿童癫痫发作的转归大多良好,无发作率可达50%以上。病因、综合征类型、起病年龄与发作控制的远期转归有关,起病年龄小、症状性或隐原性癫痫及婴儿痉挛等特殊综合征类型预后不良。更多还原

【Abstract】 Objective: To analyze the long-term outcome of seizures,and to explore the effects of related factors,including the age at onset,types of epileptic syndromes,and etiological factors,etc. Methods: The clinical data were retrospectively surveyed from 265 children with regular follow-ups for over 1 year at Peking University First Hospital( Jan. 2003 to Dec. 2006). The seizure-free rate was calculated as an at least one-year non-occurrence of seizures. The long-term outcome of seizures was analyzed in association with factors including the age at onset,types of epileptic syndromes,and etiology. Results:( 1) Seizure types were clarified in all the cases,with combined types of seizures in 17. Epileptic syndromes were identified in 163 /265 cases( 61. 5%). With regular antiepileptic drug therapy, 57. 9% children with epilepsy could be seizure-free.( 2) Seizure-free was demonstrated in 142 /265 cases with a seizure-free rate of 53. 6% in this group.( 3) The age at onset was youngest in the non-efficacy group.( 4) The seizure-free rate was different by syndrome types of epilepsies,with a higher seizurefree rate in idiopathic generalized epilepsy( 72. 4%) and benign epilepsy in children with centro-temporal spikes( 65. 5%),whereas a lowest rate( 21. 7%) in infantile spasms.( 5) A significant difference of seizure-free rates was revealed in different etiological groups. Children with idiopathic epilepsy achieved higher seizure-free rate( 69. 2%) than those with symptomatic and cryptogenic epilepsy( 45. 4%). Conclusion: The epilepsy children with regular antiepileptic drug therapy had generally satisfactory outcome of seizures,with over half cases of seizure-free. The prognosis was demonstrated to be closely related with the etiological factors,syndrome types and age at onset.更多还原