Salih Muhannad Rm, Bahari Mohd Baldi, Hassali Mohamed Azmi Ahmad, Shafie Asrul Akmal, Al-Lela Omer Qutaiba B, Abd Arwa Y, Ganesan Vigneswari M
College of Pharmacy, Al-Rashed University, Baghdad, Iraq.
J Neurosci Rural Pract. 2012 Sep;3(3):244-50. doi: 10.4103/0976-3147.102596.
Seizure-free patients or substantial reduction in seizure frequency are the most important outcome measures in the management of epilepsy. The study aimed to evaluate the patterns of seizure frequency and its relationship with demographics, clinical characteristics, and outcomes.
A retrospective cohort study was conducted at the Pediatric Neurology Clinic, Hospital Pulau Pinang. Over a period of 6 months, the required data were extracted from the medical records using a pre-designed data collection form.
Seizure frequency showed no significant association with patient's demographics and clinical characteristic. However, significant reduction in seizure frequency from the baseline to the last follow-up visit was only seen in certain subgroups of patients including Malays, females, patients <4 years of age, patients with global developmental delay/intellectual disability, and patients with focal seizure. There was no significant association between seizure frequency and rate of adverse events. Polytherapy visits were associated with higher seizure frequency than monotherapy visits (27.97 ± 56.66, 10.94 ± 30.96 attack per month, respectively) (P < 0.001). There was a clear tendency to get antiepileptic drugs used at doses above the recommended range in polytherapy (8.4%) rather than in monotherapy (1.4%) visits (P < 0.001). A significant correlation was found between seizure frequency and number of visits per patient per year (r = 0.450, P < 0.001).
Among children with structural-metabolic epilepsy, Malays, females, patients <4 years of age, patients with global developmental delay/intellectual disability and patients manifested with focal seizure are more responsive antiepileptic drug therapy than the other subgroups of patients.
癫痫患者实现无癫痫发作或癫痫发作频率大幅降低是癫痫治疗中最重要的疗效指标。本研究旨在评估癫痫发作频率模式及其与人口统计学、临床特征和治疗结果的关系。
在槟城医院儿科神经科诊所进行了一项回顾性队列研究。在6个月的时间里，使用预先设计的数据收集表从病历中提取所需数据。
癫痫发作频率与患者的人口统计学和临床特征无显著关联。然而，仅在某些亚组患者中观察到从基线到最后一次随访时癫痫发作频率显著降低，这些亚组包括马来人、女性、4岁以下患者、全球发育迟缓/智力残疾患者以及局灶性癫痫患者。癫痫发作频率与不良事件发生率之间无显著关联。联合治疗就诊的癫痫发作频率高于单一治疗就诊（分别为每月27.97±56.66次发作、10.94±30.96次发作）（P<0.001）。联合治疗（8.4%）比单一治疗（1.4%）就诊时更明显倾向于使用高于推荐范围剂量的抗癫痫药物（P<0.001）。发现癫痫发作频率与每位患者每年的就诊次数之间存在显著相关性（r=0.450，P<0.001）。
在结构性-代谢性癫痫儿童中，马来人、女性、4岁以下患者、全球发育迟缓/智力残疾患者以及表现为局灶性癫痫的患者比其他亚组患者对抗癫痫药物治疗反应更好。
