Xiao Fenglai, An Dongmei, Chen Sihan, Ren Jiechuan, Zhou Dong
Department of Neurology, West China Hospital, SiChuan University, Chengdu, Sichuan, People's Republic of China.
Department of Neurology, West China Hospital, SiChuan University, Chengdu, Sichuan, People's Republic of China
J Child Neurol. 2015 Oct;30(12):1591-7. doi: 10.1177/0883073815575367. Epub 2015 Mar 19.
The aim of this study is to identify clinical or electroencephalographic (EEG) features associated with refractoriness to the initial antiepileptic drug in typical benign childhood epilepsy with centrotemporal spikes. A total of 87 children with typical benign childhood epilepsy with centrotemporal spikes were retrospectively reviewed in the analyses. The patients were subdivided into 2 groups: patients whose seizures were controlled with monotherapy and patients requiring 2 medications. Sixty-three children achieved seizure freedom with monotherapy, whereas 24 received 2 medications for seizure control. Diffusing foci at the follow-up EEG and delayed treatment (duration >1 year) are 2 main risk factors associated with more refractory cases (P < .001). Delayed diagnosis (37.1%) and nonadherence to treatment (57.2%) contributed to delayed treatment. Our findings suggested that diffusing foci on EEG and delayed treatment are associated with more frequent seizures and refractoriness in benign childhood epilepsy with centrotemporal spikes. Diagnostic delays and nonadherence hindered timely care, which may represent opportunities for improved intervention.
本研究的目的是确定与伴有中央颞区棘波的典型良性儿童癫痫对初始抗癫痫药物难治性相关的临床或脑电图(EEG)特征。分析中对87例伴有中央颞区棘波的典型良性儿童癫痫患儿进行了回顾性研究。患者被分为两组:单药治疗可控制癫痫发作的患者和需要两种药物治疗的患者。63例患儿单药治疗后癫痫发作得到控制,而24例接受两种药物治疗以控制癫痫发作。随访脑电图上的弥漫性病灶和延迟治疗(病程>1年)是与更难治性病例相关的两个主要危险因素(P<.001)。延迟诊断(37.1%)和不坚持治疗(57.2%)导致了延迟治疗。我们的研究结果表明,脑电图上的弥漫性病灶和延迟治疗与伴有中央颞区棘波的良性儿童癫痫更频繁的癫痫发作和难治性相关。诊断延迟和不坚持治疗阻碍了及时治疗,这可能是改善干预的机会。