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青少年失神癫痫患儿的预后

Outcome of children with juvenile absence epilepsy.

作者信息

Tovia Eliel, Goldberg-Stern Hadassa, Shahar Eli, Kramer Uri

机构信息

Epilepsy Unit, Schneider Children's Medical Center, Petah Tiqva, Israel.

出版信息

J Child Neurol. 2006 Sep;21(9):766-8. doi: 10.1177/08830738060210092101.

Abstract

The incidence and natural history of childhood absence epilepsy are well documented, but those of juvenile absence epilepsy are poorly delineated. We conducted a retrospective chart study to evaluate the incidence and outcome of patients with juvenile absence epilepsy by retrieving the medical records of consecutive patients with juvenile absence epilepsy who were evaluated in three pediatric neurology outpatient clinics in Israel. Inclusion criteria included the onset of epilepsy after the age of 10 years and follow-up until at least 15 years of age. The patients with an electroencephalogram (EEG) suggestive of myoclonic epilepsy (polyspike and wave) were excluded from the study. Seventeen patients (10 female and 7 male) fulfilled the inclusion criteria for juvenile absence epilepsy. They presented with epilepsy at a mean age of 11.94 years (range 10-16.5 years). The mean duration of follow-up was 6.05 years (range 2-12 years). Five patients (29.4%) had a family history of epilepsy. All 17 patients had a normal neurodevelopmental status. Eight patients (47%) experienced generalized tonic-clonic seizures. At follow-up, eight patients (43.7%) were seizure free. Only three (37.5%) of the patients who experienced generalized tonic-clonic seizures were seizure free during follow-up compared with five (55.5%) patients without generalized tonic-clonic seizures. Our results indicate that the outcome of patients with juvenile absence epilepsy is less favorable than children with childhood absence epilepsy and that the presence of generalized tonic-clonic seizures is a predictor for poorer outcome.

摘要

儿童失神癫痫的发病率及自然病史已有充分记录,但青少年失神癫痫的相关情况却描述甚少。我们开展了一项回顾性病历研究,通过检索在以色列三家儿科神经科门诊接受评估的连续性青少年失神癫痫患者的病历,来评估青少年失神癫痫患者的发病率及预后情况。纳入标准包括癫痫发作起始于10岁之后且随访至至少15岁。脑电图提示肌阵挛癫痫(多棘波和波)的患者被排除在研究之外。17例患者(10例女性和7例男性)符合青少年失神癫痫的纳入标准。他们癫痫发作的平均年龄为11.94岁(范围10 - 16.5岁)。平均随访时长为6.05年(范围2 - 12年)。5例患者(29.4%)有癫痫家族史。所有17例患者神经发育状态均正常。8例患者(47%)经历过全身强直阵挛发作。随访时,8例患者(43.7%)无癫痫发作。在经历过全身强直阵挛发作的患者中,随访期间无癫痫发作的仅3例(37.5%),而未经历过全身强直阵挛发作的患者中有5例(55.5%)无癫痫发作。我们的结果表明,青少年失神癫痫患者的预后不如儿童失神癫痫患者,且全身强直阵挛发作的存在是预后较差的一个预测因素。

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