Divisions of Epilepsy and Child and Adolescent Neurology, Department of Neurology, Mayo Clinic, Rochester, Minnesota 55905, USA.
Epilepsia. 2013 May;54 Suppl 2:19-22. doi: 10.1111/epi.12179.
Approximately 20% of children with epilepsy will be pharmacoresistant. The impact of intractable epilepsy extends far beyond just the seizures to result in intellectual disability, psychiatric comorbidity, physical injury, sudden unexpected death in epilepsy (SUDEP), and poor quality of life. Various predictors of pharmacoresistance have been identified; however, accurate prediction is still challenging. Population-based epidemiologic studies show that the majority of children who develop pharmacoresistance do so relatively early in the course of their epilepsy. However, approximately one third of children who initially appear pharmacoresistant in the first few years after epilepsy onset will ultimately achieve seizure freedom without surgery. The most significant predictor that early pharmacoresistance will not remit is the presence of a neuroimaging abnormality. Such children should be strongly considered for surgical evaluation.
约 20%的癫痫患儿会出现药物抵抗。难治性癫痫的影响不仅局限于癫痫发作，还会导致智力残疾、精神共病、身体损伤、癫痫猝死 (SUDEP) 和生活质量差。已经确定了各种药物抵抗的预测因素；然而，准确的预测仍然具有挑战性。基于人群的流行病学研究表明，大多数出现药物抵抗的儿童在癫痫发作的早期就出现了这种情况。然而，大约三分之一的儿童在癫痫发作后的最初几年内最初表现出药物抵抗，但最终无需手术即可实现无癫痫发作。早期药物抵抗不会缓解的最显著预测因素是神经影像学异常的存在。对于这类儿童，应强烈考虑手术评估。
