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影响脑瘫患者癫痫发展和癫痫预后的因素。

Factors affecting epilepsy development and epilepsy prognosis in cerebral palsy.

机构信息

Department of Pediatrics, Cukurova University, Adana, Turkey.

出版信息

Pediatr Neurol. 2011 Aug;45(2):89-94. doi: 10.1016/j.pediatrneurol.2011.03.001.

Abstract

A study was conducted between November 2006 and October 2009 to determine the factors predicting the presence and prognosis of epilepsy in patients with cerebral palsy. We enrolled 2 groups of patients: 42 with cerebral palsy in group 1 and 56 patients with cerebral palsy and epilepsy in group 2. The subjects in group 2 were considered to have good epilepsy prognosis if they were free of seizures for the previous year; otherwise they were considered to have poor epilepsy prognosis. In group 2, neonatal epilepsy, family history of epilepsy, and moderate to severe mental retardation were significantly higher than in group 1 (P < 0.05). In univariate analysis, neonatal seizures, epileptic activity as measured by electroencephalography, and polytherapy were found to be predictors of poor epilepsy prognosis. Additionally, the need for long-term medication to control seizures unfavorably affects prognosis. In logistic regression analysis, neonatal seizure and interictal epileptic activity in electroencephalography were found to be independent predictors of poor epilepsy outcome. In addition, logistic regression analysis revealed that increasing age reduces the success of epilepsy treatment. Neonatal seizures, family history of epilepsy, and mental retardation were found to be important and independent predictors of development of epilepsy in patients with cerebral palsy.

摘要

一项研究于 2006 年 11 月至 2009 年 10 月进行,旨在确定预测脑瘫患者癫痫发生和预后的因素。我们纳入了两组患者:42 例脑瘫患者归入组 1,56 例脑瘫合并癫痫患者归入组 2。组 2 中如果患者过去一年无发作则被认为癫痫预后良好,否则则被认为癫痫预后不良。组 2 中新生儿癫痫、癫痫家族史和中重度精神发育迟滞的比例显著高于组 1(P < 0.05)。单因素分析发现,新生儿发作、脑电图上的癫痫活动和多种药物治疗是癫痫预后不良的预测因素。此外,需要长期药物治疗来控制发作也对预后产生不利影响。在逻辑回归分析中,新生儿发作和脑电图中的发作间期癫痫活动被发现是癫痫预后不良的独立预测因素。此外,逻辑回归分析显示,年龄增长会降低癫痫治疗的成功率。新生儿发作、癫痫家族史和精神发育迟滞是脑瘫患者发生癫痫的重要且独立的预测因素。

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