Columbia Comprehensive Epilepsy Center, The Neurological Institute, New York, NY 10032, USA.
Curr Neurol Neurosci Rep. 2011 Aug;11(4):409-17. doi: 10.1007/s11910-011-0199-6.
Until recently, very little data existed on long-term seizure prognosis of patients with intractable epilepsy. We review recent work that assessed seizure remission in patients with intractable epilepsy during medical management. Recent prevalence cohort studies among adults with longstanding intractable epilepsy have demonstrated notable proportions of patients attaining at least 1-year seizure freedom, ranging from more than 10% to nearly 30% of patients, when followed for mean duration of 18 months to 6 years. Additionally, a recent prospective cohort study of pediatric-onset intractable epilepsy (followed prospectively for seizure outcome from onset of intractability) revealed minimum 1-year seizure remission among more than half of study patients. Despite the notable rates of remission seen among patients with intractable epilepsy, many individuals experienced subsequent seizure relapse. These findings highlight the continued importance of surgical therapy for those who are good candidates and the need for further development of effective therapeutic interventions.
直到最近，关于难治性癫痫患者长期癫痫预后的数据还很少。我们回顾了最近评估难治性癫痫患者在药物治疗期间癫痫缓解的研究。最近对长期难治性癫痫成人进行的流行队列研究表明，在平均随访 18 个月至 6 年期间，有相当比例的患者至少达到 1 年无癫痫发作，比例从 10%以上到近 30%不等。此外，最近一项关于儿童起病的难治性癫痫的前瞻性队列研究（前瞻性地从难治性开始跟踪癫痫结局）显示，超过一半的研究患者至少有 1 年的癫痫缓解。尽管难治性癫痫患者的缓解率显著，但许多人随后出现癫痫复发。这些发现强调了手术治疗对那些合适患者的持续重要性，以及需要进一步开发有效的治疗干预措施。
