Ottman R, Annegers J F, Hauser W A, Kurland L T
Gertrude H. Sergievsky Center, School of Public Health, Columbia University, New York, New York 10032.
Epilepsia. 1989 Mar-Apr;30(2):157-61. doi: 10.1111/j.1528-1157.1989.tb05448.x.
Genetic factors are commonly assumed to play a more important role in generalized than in partial epilepsy. This study tested this hypothesis by comparing risks of unprovoked seizures in offspring of individuals with generalized versus partial epilepsy. Overall, seizure incidence was no higher in offspring of persons with generalized epilepsy than in offspring of those with partial epilepsy. The number of affected offspring was about three times that expected from population incidence rates, regardless of whether the parent had partial or generalized epilepsy. For the subgroup of generalized cases with absence seizures, however, seizure incidence in offspring was about three times as high as for partial cases. The higher incidence in offspring of absence cases was only partly explained by a higher proportion of absence than partial cases with two factors associated with high risk in relatives, namely early age at onset and idiopathic epilepsy. Offspring of absence cases had higher risk than offspring of other cases not only for absence seizures, but for other seizure types as well, suggesting that absence epilepsy is not genetically distinct from other seizure types of epilepsy. These results suggest that the higher incidence sometimes observed in relatives of patients with generalized epilepsy is due to a small proportion of generalized cases with extremely high familial risks--most generalized epilepsies are no more likely than partial epilepsies to have a genetic basis.
通常认为，遗传因素在全身性癫痫中比在部分性癫痫中发挥着更重要的作用。本研究通过比较全身性癫痫患者与部分性癫痫患者后代中特发性癫痫发作的风险来验证这一假设。总体而言，全身性癫痫患者后代的癫痫发作发生率并不高于部分性癫痫患者的后代。无论父母患有部分性癫痫还是全身性癫痫，受影响后代的数量约为根据人群发病率预期数量的三倍。然而，对于伴有失神发作的全身性癫痫亚组，其后代的癫痫发作发生率约为部分性癫痫患者后代的三倍。失神发作患者后代中较高的发病率，仅有部分原因是与亲属高风险相关的两个因素（即发病年龄早和特发性癫痫）在失神发作患者中所占比例高于部分性癫痫患者。失神发作患者的后代不仅患失神发作的风险高于其他类型患者的后代，患其他类型癫痫发作的风险也更高，这表明失神癫痫与其他类型的癫痫在遗传上并无明显差异。这些结果表明，全身性癫痫患者亲属中有时观察到的较高发病率是由于一小部分全身性癫痫病例具有极高的家族风险——大多数全身性癫痫与部分性癫痫相比，遗传基础的可能性并无差异。
