Reijs Rianne P, van Mil Saskia G M, van Hall Mariette H J A, Arends Johan B A M, Weber Jacobiene W, Renier Willy O, Aldenkamp Albert P
Department of Research and Development, Epilepsy Centre Kempenhaeghe, Heeze, The Netherlands.
Seizure. 2007 Jul;16(5):438-44. doi: 10.1016/j.seizure.2007.03.007. Epub 2007 Apr 25.
One-third of children with epilepsy are classified as having a cryptogenic localization related epilepsy (CLRE). In cohort studies CLRE is often grouped together with either symptomatic localization related epilepsy (SLRE) or idiopathic generalized epilepsy (IGE). Therefore, this categorization is not specific enough and will not lead to prognostic or treatment information. We objectified the classification differences between these categories.
A total of 114 children admitted to our epilepsy centre underwent a standardized clinical analysis, which yielded age at onset, duration of the epilepsy, seizure frequency, seizure type, percentage of interictal epileptiform activity on EEG (IEA), type of treatment, and full scale IQ. These variables are regarded the characteristics of the epilepsy, and used in a discriminant function analysis.
IEA was found to be the only variable to distinguish between groups of epilepsy. SLRE could easily be distinguished significantly from IGE and CLRE, while the latter two did not differ significantly. Discriminant function analysis combined the variables into two functions, applicable to classify the children. By applying this statistical analysis method, the groups clinically classified as SLRE and IGE were mostly classified as SLRE (71.4%) and IGE (57.9%). However, CLRE appeared difficult to classify (49.2%), and most children were classified as either SLRE (19%) or IGE (31.7%).
The current opinion that CLRE is 'probably symptomatic' cannot be confirmed in all cases in this study. It is most likely that the current CLRE population consists of both children with eventually SLRE, as well as yet to be described syndromes to be classified as idiopathic epilepsies. We emphasize the need for separate studies regarding children with 'probably symptomatic' (cryptogenic) localization related epilepsy, as this will maximally help children, caretakers and treating physicians to achieve the best possible outcome.
三分之一的癫痫儿童被归类为隐源性局灶性相关性癫痫（CLRE）。在队列研究中，CLRE常与症状性局灶性相关性癫痫（SLRE）或特发性全身性癫痫（IGE）归为一组。因此，这种分类不够具体，无法得出预后或治疗信息。我们明确了这些类别之间的分类差异。
共有114名入住我们癫痫中心的儿童接受了标准化临床分析，得出了发病年龄、癫痫持续时间、发作频率、发作类型、脑电图（EEG）发作间期癫痫样放电（IEA）百分比、治疗类型和全量表智商。这些变量被视为癫痫的特征，并用于判别函数分析。
发现IEA是区分癫痫组别的唯一变量。SLRE很容易与IGE和CLRE显著区分开来，而后两者之间没有显著差异。判别函数分析将变量合并为两个函数，适用于对儿童进行分类。通过应用这种统计分析方法，临床分类为SLRE和IGE的组大多被分类为SLRE（71.4%）和IGE（57.9%）。然而，CLRE似乎难以分类（49.2%），大多数儿童被分类为SLRE（19%）或IGE（31.7%）。
本研究中并非所有病例都能证实目前认为CLRE“可能为症状性”的观点。目前的CLRE人群很可能既包括最终诊断为SLRE的儿童，也包括有待描述的将被归类为特发性癫痫的综合征。我们强调需要对“可能为症状性”（隐源性）局灶性相关性癫痫儿童进行单独研究，因为这将最大程度地帮助儿童、照料者和治疗医生取得最佳可能结果。
Zotero 插件