Ochoa-Gómez Laura, López-Pisón Javier, Fuertes-Rodrigo Cristina, Fernando-Martínez Ruth, Samper-Villagrasa Pilar, Monge-Galindo Lorena, Peña-Segura José Luis
HUMS. Hospital Universitario Miguel Servet, 50009 Zaragoza, Espana.
Hospital Clinico Universitario Lozano Blesa, 50009 Zaragoza, Espana.
Rev Neurol. 2016 Feb 16;62(4):145-51.
To analyze the factors involved in the prognosis of non-symptomatic epilepsy (idiopathic and cryptogenic) in relation to their age of onset, monitored at a regional section of Neuropediatry reference over a period of three years.
Patients with diagnosis of non-symptomatic epilepsy supervised from January 1, 2008 to December 31, 2010, collecting epidemiological, clinical, complementary examinations and developmental data.
Of the 4595 children attended during the period, the diagnosis of epilepsy was established in 605 (13.17%): 156 (25.79%) idiopathic epilepsies and 172 (28.43%) cryptogenic epilepsies. 15.7% of cryptogenic epilepsies and 14.1% of idiopathic epilepsies are refractory to treatment. Some epileptic syndromes, such as reflex epilepsies, Dravet syndrome, Ohtahara syndrome or Lennox-Gastaut syndrome, have higher rates of drug resistance. 84.62% of idiopathic epilepsies and 79.77% of cryptogenic epilepsies present no other associated neurological disorder.
A useful classification would be etiological, with two groups: a large group with established etiology or very likely genetic syndromes and another with no established cause. The age of onset of epilepsy in each etiological group adds prognostic orientation. Prognosis of epilepsy is worsened by refractoriness and associated neurodevelopmental disorders, and are generally worse at an earlier onset and in certain etiologies.
分析在三年时间里,于神经儿科参考区域监测的无症状癫痫(特发性和隐源性)预后相关因素与其发病年龄的关系。
对2008年1月1日至2010年12月31日期间确诊为无症状癫痫的患者进行监测,收集流行病学、临床、辅助检查及发育数据。
在此期间就诊的4595名儿童中,605名(13.17%)被确诊为癫痫:156名(25.79%)为特发性癫痫,172名(28.43%)为隐源性癫痫。15.7%的隐源性癫痫和14.1%的特发性癫痫对治疗难治。一些癫痫综合征,如反射性癫痫、德雷维特综合征、大田原综合征或伦诺克斯 - 加斯东综合征,耐药率较高。84.62%的特发性癫痫和79.77%的隐源性癫痫无其他相关神经系统疾病。
一种有用的分类是病因学分类,分为两组:一组病因明确或很可能是遗传综合征,另一组病因不明。每个病因学组中癫痫的发病年龄增加了预后导向性。癫痫的预后因难治性和相关神经发育障碍而恶化,并且通常在发病较早和某些病因时更差。