Kafle D R, Oli K K
Department of Internal Medicine, Nobel Medical College, Biratnagar, Nepal.
Department of Neurology, Institute of Medicine, TUTH, Kathmandu, Nepal.
Kathmandu Univ Med J (KUMJ). 2014 Jul-Sep;12(47):202-6. doi: 10.3126/kumj.v12i3.13719.
Epilepsy is a common and diverse disorder with many different causes. Outcomes are varied with 60-70% of newly diagnosed people rapidly entering remission after starting treatment and 20-30% developing a drug-resistant epilepsy with consequent clinical and psychosocial distress. About one third of patients with a first unprovoked seizure will have further seizures within five years, and about three quarters of those with two or three unprovoked seizures have further seizures within four years.
The aim of the study was to find out those factors which were associated with recurrence of seizure in Nepalese population.
It is a Descriptive Cross-sectional study which was conducted in Tribhuvan University Teaching Hospital from January 2013 to January 2014.
A total of 150 patients participated in the study. Neuroimaging was normal in 65(43.3%) patients. 48(32%) patients had neurocystercosis in their brain imaging, neuroinfection in 12(8%) of cases, cerebral infarction in 12(8%), Cerebral atrophy in 5(3.3%) patients, brain tumor in 4(2.7%), Mesial temporal sclerosis in 2(1.3%), tuberous sclerosis in 1(0.7%) and hypoxic brain injury in 1 (0.7%) patient. 14(9.3%) patients reported having a family history of epilepsy in first degree relative. There was statistically significant association between higher number of seizures before starting medication and increased frequency of seizure after starting medication (p<0.001).
Most of the patients with recurrent seizure had identifiable cause. Neurocysticercosis was the most common cause. Higher number of seizure before starting medication was associated with increased frequency of seizure after starting medication.
癫痫是一种常见且多样的疾病，病因众多。其预后各不相同，60% - 70%新诊断的患者在开始治疗后迅速进入缓解期，20% - 30%发展为药物难治性癫痫，随之而来的是临床和社会心理困扰。约三分之一首次无诱因发作的患者在五年内会再次发作，约四分之三有两次或三次无诱因发作的患者在四年内会再次发作。
本研究的目的是找出尼泊尔人群中与癫痫复发相关的因素。
这是一项描述性横断面研究，于2013年1月至2014年1月在特里布万大学教学医院进行。
共有150名患者参与了该研究。65名（43.3%）患者的神经影像学检查正常。48名（32%）患者的脑部影像学检查显示有神经囊尾蚴病，12名（8%）病例有神经感染，12名（8%）有脑梗死，5名（3.3%）患者有脑萎缩，4名（2.7%）有脑肿瘤，2名（1.3%）有内侧颞叶硬化，1名（0.7%）有结节性硬化，1名（0.7%）患者有缺氧性脑损伤。14名（9.3%）患者报告一级亲属有癫痫家族史。开始用药前发作次数较多与开始用药后发作频率增加之间存在统计学显著关联（p<0.001）。
大多数癫痫复发患者有可识别的病因。神经囊尾蚴病是最常见的病因。开始用药前发作次数较多与开始用药后发作频率增加有关。
