Department of Neurology and Rehabilitation, Tampere University Hospital, Tampere, Finland.
Acta Neurol Scand. 2010 Sep;122(3):196-201. doi: 10.1111/j.1600-0404.2009.01292.x. Epub 2009 Nov 16.
To characterize adult patients with idiopathic generalized epilepsies (IGEs) with precise evaluation and to assess factors related to refractoriness.
Hospital records of all our patients with IGEs (n = 128) were evaluated in 2005 and followed-up until 2008.
In 2005, 76% of patients were 1-year seizure-free. Seizure freedom increased to 82% during the 3-year follow-up. Seizure freedom was not significantly associated with age, age at diagnosis, epilepsy duration, exposure to inappropriate initial antiepileptic drug (AED), or delay time between starting initial AED and appropriate AED. Women constituted 78% of patients with merely provoked seizures. In 58% of women with recent seizure, one to two avoidable precipitating factors, such as lack of sleep, alcohol, and forgetting to take AED, were observed. In 2008, all patients with no medication, 91% of monotherapy patients, 60% of patients on two AED, and 14% of patients on three AED were seizure-free.
Most of patients with IGEs can be successfully treated with monotherapy. Refractory seizures in some patients may be because of avoidable factors, especially in young women.
通过精确评估,对特发性全面性癫痫(IGE)的成年患者进行特征描述,并评估与耐药相关的因素。
2005 年对我院所有 IGE 患者(n=128)的病历进行评估,并随访至 2008 年。
2005 年,76%的患者在 1 年内无发作。在 3 年的随访中,无发作率增加至 82%。无发作与年龄、诊断时的年龄、癫痫持续时间、初始抗癫痫药物(AED)不当暴露或初始 AED 与适当 AED 开始之间的延迟时间无关。仅有诱发性发作的患者中,女性占 78%。在 58%近期有发作的女性中,观察到一到两个可避免的诱发因素,如睡眠不足、饮酒和忘记服用 AED。2008 年,所有不服药的患者、91%的单药治疗患者、60%的两种 AED 治疗患者和 14%的三种 AED 治疗患者均无发作。
大多数 IGE 患者可以通过单药治疗成功治疗。一些患者的耐药性癫痫可能是由于可避免的因素引起的,尤其是年轻女性。