Beghi Ettore, Camfield Peter R, Camfield Carol S
Department of Neuroscience, IRCCS Institute for Pharmacological Research "Mario Negri", Milan, Italy.
Epilepsia. 2014 Aug;55 Suppl 3:3-7. doi: 10.1111/epi.12703.
Population-based studies focusing on the long-term prognosis of childhood-onset epilepsy show that despite seizure remission in 70-80% of cases, cognitive, behavioral and psychosocial complications are common and will require management and monitoring in adulthood. This type of study design also demonstrates that death is rare in children who are intellectually and neurologically normal and followed for many years, which is the same for the general population. Only those children with neurologic problems sufficiently severe to interfere with activities of daily living have an increased risk of death in childhood. Investigation of potentially remediable complications is paramount, and the use of antiepileptic medications with potential adverse cognitive and behavioral effects should be identified and eliminated or reduced. In addition, education of the family should be improved. As well, identification and control of social and psychiatric complications is necessary and implies a comprehensive management of the patient before and after the transition from childhood into adulthood.
以人群为基础的关于儿童期癫痫长期预后的研究表明，尽管70%-80%的病例癫痫发作得到缓解，但认知、行为和心理社会并发症很常见，在成年期需要进行管理和监测。这种研究设计还表明，在智力和神经方面正常且经过多年随访的儿童中，死亡情况很少见，这与一般人群相同。只有那些神经问题严重到足以干扰日常生活活动的儿童在童年期死亡风险才会增加。对潜在可补救并发症的调查至关重要，应识别并消除或减少使用具有潜在不良认知和行为影响的抗癫痫药物。此外，应改善对家庭的教育。同时识别和控制社会及精神并发症是必要的，这意味着在儿童向成人过渡之前和之后对患者进行全面管理。
