Franzoni Emilio, Matricardi Sara, Di Pisa Veronica, Capovilla Giuseppe, Romeo Antonino, Tozzi Elisabetta, Pruna Dario, Salerno Grazia Gabriella, Zamponi Nelia, Accorsi Patrizia, Giordano Lucio, Coppola Giangennaro, Cerminara Caterina, Curatolo Paolo, Nicita Francesco, Spalice Alberto, Grosso Salvatore, Pavone Piero, Striano Pasquale, Parisi Pasquale, Boni Antonella, Gobbi Giuseppe, Carotenuto Marco, Esposito Maria, Cottone Carlo, Verrotti Alberto
Child Neuropsychiatry Unit, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Department of Pediatrics, University of Chieti, Chieti, Italy.
Eur J Paediatr Neurol. 2015 Nov;19(6):660-4. doi: 10.1016/j.ejpn.2015.07.008. Epub 2015 Jul 18.
To evaluate evidence and prognosis of refractory cases of absence seizures.
Subjects with refractory absence seizures were identified retrospectively in 17 Italian epilepsy pediatrics Centers. We analyzed age at onset, family history, presence of myoclonic components, seizure frequency, treatment with antiepileptic drugs (AEDs), interictal electroencephalography (EEG) and neuropsychological assessment. Two subgroups were identified: one with patients with current absence seizures and another with patients that had become seizure free with or without AED treatment. The chi-square test was applied.
A total of 92 subjects with drug-resistant absence seizures were analyzed. 45 subjects still show absence seizures (49%) and the other 47 became seizure free (51%) after a period of drug-resistance. The statistical analysis between these two groups showed no correlation between age of onset, family history and abnormalities at interictal EEG. Statistically significant differences were observed with regard to the number of AEDs used and intellectual disability.
Typical absence epilepsy classifiable as Childhood Absence Epilepsy could not be considered so "benign", as suggested in literature. A longer duration of disease and a higher frequency of seizure seem to be correlated with a higher presence of cognitive impairment. No significant risk factor was observed to allow the faster and better recognition of patients with worse prognosis.
评估失神发作难治性病例的证据和预后。
在17个意大利癫痫儿科中心对难治性失神发作患者进行回顾性鉴定。我们分析了发病年龄、家族史、肌阵挛成分的存在、发作频率、抗癫痫药物（AED）治疗、发作间期脑电图（EEG）和神经心理学评估。确定了两个亚组：一个是目前有失神发作的患者，另一个是无论是否接受AED治疗均已无发作的患者。应用卡方检验。
共分析了92例耐药性失神发作患者。45例患者仍有失神发作（49%），另外47例在一段耐药期后无发作（51%）。这两组之间的统计分析显示，发病年龄、家族史和发作间期EEG异常之间无相关性。在使用的AED数量和智力残疾方面观察到统计学上的显著差异。
可归类为儿童失神癫痫的典型失神癫痫并非如文献中所提示的那样“良性”。疾病持续时间较长和发作频率较高似乎与认知障碍的较高发生率相关。未观察到显著的危险因素可用于更快、更好地识别预后较差的患者。
