Scotoni Anna E, Manreza Maria L G, Guerreiro Marilisa M
Department of Neurology, University of Campinas, Campinas, Brazil.
Epilepsia. 2004 Feb;45(2):166-70. doi: 10.1111/j.0013-9580.2004.16503.x.
To evaluate the recurrence risk after a first unprovoked seizure in a large population of children and adolescents of a developing country.
This prospective study was conducted at two tertiary hospitals, between September 1989 and August 1998. Children were enrolled if they had a first unprovoked cryptogenic/idiopathic seizure and maximal interval to the enrollment < or =90 days. EEG and computed tomography (CT) were performed in most patients. Potential predictors of recurrence were compared by using the Cox proportional hazards model in univariate and multivariate analyses. Survival analysis was performed by using the Kaplan-Meier curves.
Two hundred thirteen children were included. Recurrence occurred in 34% of the patients, and mean time for recurrence was 12 months. Statistical analysis showed significance for seizure recurrence only for patients with abnormal EEGs. CT was performed in 182 patients, and abnormalities were found in 9.5%. Small calcifications were the most frequent finding, and this was not a predictor for recurrence.
The risk of recurrence after a first unprovoked seizure in children from a developing country is similar to that found in developed countries. An abnormal EEG is a risk factor for seizure recurrence in children with a cryptogenic/idiopathic seizure. Calcifications on CT do not increase the risk of recurrence.
评估发展中国家大量儿童和青少年首次无诱因癫痫发作后的复发风险。
这项前瞻性研究于1989年9月至1998年8月在两家三级医院进行。纳入首次出现无诱因隐源性/特发性癫痫发作且入组时最大间隔时间≤90天的儿童。大多数患者进行了脑电图（EEG）和计算机断层扫描（CT）检查。通过Cox比例风险模型进行单因素和多因素分析，比较复发的潜在预测因素。采用Kaplan-Meier曲线进行生存分析。
共纳入213名儿童。34%的患者出现复发，平均复发时间为12个月。统计分析显示，仅脑电图异常的患者癫痫复发具有统计学意义。182例患者进行了CT检查，9.5%发现异常。小钙化是最常见的发现，但这不是复发的预测因素。
发展中国家儿童首次无诱因癫痫发作后的复发风险与发达国家相似。脑电图异常是隐源性/特发性癫痫发作儿童癫痫复发的危险因素。CT上的钙化不会增加复发风险。
