Waaler P E, Blom B H, Skeidsvoll H, Mykletun A
Department of Pediatrics, Haukeland University Hospital, Bergen, Norway.
Epilepsia. 2000 Jul;41(7):802-10. doi: 10.1111/j.1528-1157.2000.tb00246.x.
To determine prevalence of active epilepsy in school children in a defined area and assess the usefulness of International League Against Epilepsy classification of seizures and epileptic syndromes, with special emphasis on frequency, additional handicaps, and therapeutic problems of severe cases.
The latest International League Against Epilepsy International Classification of Epileptic Seizures (ICES, 1981) and Epilepsies and Epileptic Syndromes (ICE, 1989) were used for determination of prevalence rates, seizure types, epilepsies and epileptic syndromes, and additional neurological deficits in all 6-to 12-year-old children with epilepsy in a Norwegian county. Children had neuropediatric and EEG examination, intelligence evaluation, and, when necessary, additional investigations.
Prevalence of active epilepsy on January 1, 1995, was 5.1 per 1,000. Main seizure type and epilepsy syndrome could be classified in 98% and 90% of patients, respectively. Seizure types/epileptic syndromes were more often partial/localization related than generalized. Among generalized epilepsies, idiopathic forms were more frequent in girls, and cryptogenic and symptomatic forms more frequent in boys. Epileptogenic EEG activity was most often generalized or localized to one or two areas of the brain and was never found in 14% of patients. Symptomatic etiology was found in 46% of all children and in 81% of therapy-resistant cases, respectively. Over the years, 11% of children had never used antiepileptic drugs (AED), 62% had tried one or two AEDs, and 26% had tried from three to 15 AEDs. Twenty-five percent of children were without present AED treatment. Complementary/alternative medicine had been tried by 12% of children.
Although most epilepsies could be classified, the number of cases in non-specific categories was relatively high. Symptomatic etiology was frequent, especially in therapy-resistant cases. Multidisciplinary therapeutic and habilitation approaches are often needed in childhood epilepsy.
确定某特定地区学龄儿童活动性癫痫的患病率，并评估国际抗癫痫联盟（International League Against Epilepsy）癫痫发作及癫痫综合征分类法的实用性，特别关注严重病例的发作频率、附加障碍及治疗问题。
采用国际抗癫痫联盟最新的癫痫发作国际分类（ICES，1981年）及癫痫与癫痫综合征分类（ICE，1989年），来确定挪威一个郡内所有6至12岁癫痫儿童的患病率、发作类型、癫痫及癫痫综合征，以及附加神经功能缺损情况。对儿童进行神经儿科和脑电图检查、智力评估，必要时进行其他检查。
199年1月1日活动性癫痫的患病率为千分之5.1。分别有98%的患者可分类出主要发作类型，90%的患者可分类出癫痫综合征。发作类型/癫痫综合征与部分性/局灶性相关的情况比全身性的更常见。在全身性癫痫中，特发性类型在女孩中更常见，隐源性和症状性类型在男孩中更常见。致痫性脑电图活动最常为全身性或局限于大脑的一两个区域，14%的患者未发现这种情况。分别有46%的所有儿童及81%的耐药病例发现有症状性病因。多年来，11%的儿童从未使用过抗癫痫药物（AED），62%的儿童尝试过一两种AED，26%的儿童尝试过三至15种AED。25%的儿童目前未接受AED治疗。12%的儿童尝试过补充/替代医学方法。
尽管大多数癫痫可以分类，但非特异性类别中的病例数量相对较高。症状性病因很常见，尤其是在耐药病例中。儿童癫痫通常需要多学科的治疗和康复方法。
