Räty Lena K, Wilde-Larsson Bodil, Söderfeldt Brigitta A
Faculty of Health Sciences, Department of Neurology, Linköping University, Linköping, Sweden.
Seizure. 2003 Jun;12(4):229-36. doi: 10.1016/s1059-1311(02)00227-3.
This study aimed to describe seizures and their therapy among Swedish adolescents, aged 13-22, with active but uncomplicated epilepsy.
The adolescents answered questionnaires (158/193). Data were also obtained from medical records.
Epileptic seizure types could be specified in 92.1% of the cases. Predominant types were Primary Generalised Tonic-Clonic Seizures and Partial Complex Seizures with Secondary Generalisation. Clinical diagnoses by physicians were unspecified in 25.8%. Ninety percent were on antiepileptic drugs (AEDs), most commonly valproate and carbamazepine. New AEDs were used in 9.3% of the cases and polytherapy in 13.9%. More than 40% of the respondents had seizures despite AED treatment. Side effects of AEDs were experienced by 61%, most commonly tiredness, concentration difficulties and headache. Patients on polytherapy experienced significantly more side effects. The choice of a new AED over a traditional one was not related to seizure type or seizure control.
Many adolescents had persistent seizures despite treatment at a specialist regional epilepsy centre. This, plus the high reported rate of side effects of AED treatment, suggests that treatment is not optimal for the group studied. As traditional AEDs strongly dominated treatment possibly newly marketed AEDs are underused in this group.
本研究旨在描述瑞典13至22岁患有活动性但无并发症癫痫的青少年的癫痫发作情况及其治疗方法。
青少年回答了问卷(158/193)。数据也从医疗记录中获取。
92.1%的病例能够明确癫痫发作类型。主要类型为原发性全面性强直阵挛发作和伴有继发性全面化的部分性复杂发作。医生的临床诊断中有25.8%未明确。90%的患者服用抗癫痫药物(AEDs),最常用的是丙戊酸盐和卡马西平。9.3%的病例使用了新型抗癫痫药物,13.9%的病例采用了联合治疗。尽管接受了AED治疗,但仍有超过40%的受访者出现癫痫发作。61%的患者经历过AED的副作用,最常见的是疲劳、注意力不集中和头痛。联合治疗的患者经历的副作用明显更多。选择新型AED而非传统AED与癫痫发作类型或癫痫控制无关。
尽管在专科区域癫痫中心接受了治疗,但许多青少年仍有持续性癫痫发作。这一点,再加上所报告的AED治疗副作用发生率较高,表明对于所研究的群体而言,治疗并非最佳。由于传统AED在治疗中占主导地位,可能新型上市的AED在该群体中未得到充分利用。