Stephen Linda J, Kelly Kevin, Mohanraj Rajiv, Brodie Martin J
Epilepsy Unit, Division of Cardiovascular and Medical Sciences, Western Infirmary, Glasgow, Scotland, UK.
Epilepsy Behav. 2006 Mar;8(2):434-7. doi: 10.1016/j.yebeh.2005.11.007. Epub 2006 Jan 4.
Old age is the most common time in life to develop epilepsy. Despite this, there are few published data exploring pharmacological outcomes in this population.
We analyzed outcomes in 117 older patients (median age, 73; range, 65-92) for whom localization-related epilepsy was newly diagnosed and treatment begun at a single center over a 20-year period.
Seventy-three (62%) patients became seizure-free for at least 12 months on their first AED, with 30 (26%) failing to respond and 14 (12%) not tolerating the treatment. Following pharmacological manipulation, 93 (79%) patients attained remission, 87 (93%) on monotherapy and 6 (7%) on duotherapy. No individual AED was more likely to confer seizure freedom than any other. Patients attaining remission were more likely to have had fewer pretreatment seizures (P=0.0078) than those who did not obtain full seizure control.
The prognosis in epilepsy may be better in older than younger people, perhaps reflecting lower lesional epileptogenicity and genetic predisposition.
老年是一生中最常发生癫痫的时期。尽管如此，关于该人群药物治疗效果的已发表数据却很少。
我们分析了117例老年患者（中位年龄73岁；范围65 - 92岁）的治疗结果，这些患者在20年期间于单一中心新诊断为局灶性相关性癫痫并开始治疗。
73例（62%）患者在首次使用抗癫痫药物（AED）时至少12个月无癫痫发作，30例（26%）无反应，14例（12%）不耐受治疗。经过药物调整后，93例（79%）患者达到缓解，87例（93%）采用单药治疗，6例（7%）采用联合治疗。没有哪种单一的AED比其他AED更有可能实现无癫痫发作。达到缓解的患者与未实现完全癫痫控制的患者相比，治疗前癫痫发作次数可能更少（P = 0.0078）。
老年人癫痫的预后可能比年轻人更好，这或许反映出较低的病灶致痫性和遗传易感性。
