Martínez-Ferrández C, Martínez-Salcedo E, Casas-Fernández C, Alarcón-Martínez H, Ibáñez-Micó S, Domingo-Jiménez R
Sección Neuropediatría, Pediatría, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España.
Sección Neuropediatría, Pediatría, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España.
Neurologia (Engl Ed). 2019 May;34(4):224-228. doi: 10.1016/j.nrl.2016.12.005. Epub 2017 Mar 18.
Childhood absence epilepsy (CAE) is considered easily manageable with medication provided that a strict patient classification system is employed. It accounts for 10% of all childhood epilepsy cases starting before the age of 15 and it is most frequent in school-aged girls. The aim of this study is to analyse long-term outcomes of patients diagnosed with CAE according to the Loiseau and Panayiotopoulos criteria and treated during childhood.
We conducted a retrospective study including 69 patients with CAE who are currently older than 11; data were gathered from medical histories, EEG records, and telephone questionnaires.
52 patients met the Loiseau and Panayiotopoulos criteria. Mean age is now 17.16 years. Female-to-male ratio was 1.65:1; mean age at onset was 6 years and 2 months; mean duration of treatment was 3 years and 9 months. A family history of epilepsy was present in 30.8% of the patients and 7.7% had a personal history of febrile convulsions. Absence seizures were simple in 73.5% of the patients and complex in 26.5%. Response rates to first-line treatment were as follows: valproic acid, 46.3%; and valproic acid plus ethosuximide, 90.9%. The rate of response to second-line therapy (ethosuximide or lamotrigine) was 84.2%; 4% of the patients experienced further seizures after treatment discontinuation, 78.8% achieved seizure remission, and 25% needed psychological and academic support.
Our data show that epileptic patients should be classified according to strict diagnostic criteria since patients with true CAE have an excellent prognosis. The relapse rate was very low in our sample. Despite the favourable prognosis, psychological and academic support is usually necessary.
儿童失神癫痫（CAE）被认为若采用严格的患者分类系统，药物治疗相对容易控制。它占15岁前发病的所有儿童癫痫病例的10%，在学龄期女孩中最为常见。本研究的目的是分析根据洛索和帕纳约托普洛斯标准诊断并在儿童期接受治疗的CAE患者的长期预后。
我们进行了一项回顾性研究，纳入69例目前年龄超过11岁的CAE患者；数据收集自病史、脑电图记录和电话调查问卷。
52例患者符合洛索和帕纳约托普洛斯标准。目前平均年龄为17.16岁。男女比例为1.65:1；平均发病年龄为6岁2个月；平均治疗时长为3年9个月。30.8%的患者有癫痫家族史，7.7%有热性惊厥个人史。73.5%的患者失神发作类型为简单型，26.5%为复杂型。一线治疗的有效率如下：丙戊酸，46.3%；丙戊酸加乙琥胺，90.9%。二线治疗（乙琥胺或拉莫三嗪）的有效率为84.2%；4%的患者在停药后再次发作，78.8%实现癫痫缓解，25%需要心理和学业支持。
我们的数据表明，癫痫患者应根据严格的诊断标准进行分类，因为真正的CAE患者预后良好。我们样本中的复发率非常低。尽管预后良好，但通常仍需要心理和学业支持。
