Brinciotti Mario, Matricardi Maria, Cantonetti Laura, Lauretti Giada, Pugliatti Maria
Department of Child Neurology and Psychiatry, University "La Sapienza," Rome, Italy.
Epilepsia. 2006;47 Suppl 5:36-40. doi: 10.1111/j.1528-1167.2006.00875.x.
To evaluate the long-term outcome of patients with pattern-sensitive epilepsy.
We prospectively studied 35 patients (21 females and 14 males) with pattern-sensitive epilepsy (follow up > or = 5 years; mean 13.9; range 6.4 - 27.6). All cases had regular clinical examinations and serial electroencephalographic (EEG) recordings. Photosensitivity and pattern sensitivity were ascertained neurophysiologically in all cases. Outcome was evaluated according to the following variables: duration of photosensitivity, rate of remission (seizure-free period > or = 2 years), withdrawal of therapy, and recurrence after drug discontinuation.
The epilepsy was generalized in 18 cases (17 idiopathic, one symptomatic) and partial in 17 (13 idiopathic, four symptomatic). Sixteen patients (46%) had a family history of seizures. The mean age at the last examination was 21.4 years (range 11.2-35.5 years). Five patients (14%) had only reflex seizures. The most common type of spontaneous seizures was generalized (60%), whereas reflex seizures were more frequently partial (74%). Mean epilepsy duration was 8.7 +/- 6.3 years. Patients with only reflex seizures were instructed to avoid precipitating stimuli and were not treated with antiepileptic drugs. Treatment was gradually withdrawn in 10 out of 30 treated patients, with relapse in only two cases. At the end of follow up, 28 patients (80%) were seizure-free.
The long-term outcome of patients with pattern-sensitive epilepsy indicates a good prognosis with a favorable course for both spontaneous and reflex seizures.
评估模式敏感性癫痫患者的长期预后。
我们前瞻性地研究了35例模式敏感性癫痫患者（21例女性，14例男性）（随访时间≥5年；平均13.9年；范围6.4 - 27.6年）。所有病例均进行了定期临床检查和系列脑电图（EEG）记录。所有病例均通过神经生理学方法确定了光敏性和模式敏感性。根据以下变量评估预后：光敏性持续时间、缓解率（无癫痫发作期≥2年）、停药情况以及停药后的复发情况。
癫痫全身性发作18例（17例特发性，1例症状性），部分性发作17例（13例特发性，4例症状性）。16例患者（46%）有癫痫家族史。末次检查时的平均年龄为21.4岁（范围11.2 - 35.5岁）。5例患者（14%）仅有反射性癫痫发作。最常见的自发性癫痫发作类型为全身性发作（60%），而反射性癫痫发作更常见为部分性发作（74%）。平均癫痫病程为8.7±6.3年。仅有反射性癫痫发作的患者被指导避免诱发刺激，未接受抗癫痫药物治疗。30例接受治疗的患者中有10例逐渐停药，仅2例复发。随访结束时，28例患者（80%）无癫痫发作。
模式敏感性癫痫患者的长期预后表明，无论是自发性癫痫发作还是反射性癫痫发作，预后良好，病程有利。
