Kharod Prarthana, Mishra Devendra, Juneja Monica
Department of Pediatrics, Lok Nayak Hospital, Maulana Azad Medical College, University of Delhi, 2, BSZ Marg, New Delhi, Delhi, 110002, India.
Department of Pediatrics, GCS Medical College, Ahmedabad, Gujarat, India.
Childs Nerv Syst. 2019 May;35(5):775-778. doi: 10.1007/s00381-019-04084-5. Epub 2019 Feb 13.
Drug-resistant epilepsy (DRE), a condition in which seizures persist and seizure freedom is unlikely to be attained with further manipulation of anti-epileptic drugs, occurs in around 20% of children with epilepsy. This study was conducted with the aim to study the profile of Indian children with resistant epilepsy, using the new consensus definition of DRE.
All children who had been attending the Pediatric Neurology Clinic regularly for at least 6 months were reviewed between April and September 2015. Children fulfilling the ILAE Commission on Therapeutic Strategies Consensus Proposal definition of DRE were enrolled for the study. After informed consent, the records were reviewed and disease-related data was entered in the study form. The data were analyzed to determine etiological factors and treatment gaps in children with DRE.
Fifty children (12 females) with median (range) age of 90 (11-159) months and follow-up of 17.9 (8.5-20) months were enrolled. The mean (standard deviation) age at seizure onset and start of anti-epileptic drugs (AED) were 1.8 (2.11) and 2.1 (2.09) years, respectively. The median (range) number of anti-epileptic drugs that had been tried in these children was 5 (2-9), with drug side effects leading to discontinuation in 8 (16%) patients. Only two patients had tried ketogenic diet; vagal nerve stimulation and epilepsy surgery had not been tried by any family, despite recommendation by the physicians in 7 children.
Majority of Indian children with DRE have onset of epilepsy in early infancy, and are infrequently provided access to newer non-pharmacological measures.
耐药性癫痫（DRE）是一种癫痫发作持续存在且通过进一步调整抗癫痫药物不太可能实现无癫痫发作的疾病，约20%的癫痫儿童会出现这种情况。本研究旨在采用新的DRE共识定义，研究印度耐药性癫痫儿童的概况。
对2015年4月至9月期间定期在儿科神经科门诊就诊至少6个月的所有儿童进行了回顾。符合国际抗癫痫联盟治疗策略委员会DRE共识提案定义的儿童被纳入研究。在获得知情同意后，查阅病历并将疾病相关数据录入研究表格。对数据进行分析，以确定DRE儿童的病因和治疗差距。
纳入了50名儿童（12名女性），中位（范围）年龄为90（11 - 159）个月，随访时间为17.9（8.5 - 20）个月。癫痫发作起始和开始使用抗癫痫药物（AED）的平均（标准差）年龄分别为1.8（2.11）岁和2.1（2.09）岁。这些儿童尝试使用的抗癫痫药物中位（范围）数量为5（2 - 9）种，其中8名（16%）患者因药物副作用而停药。只有两名患者尝试过生酮饮食；尽管7名儿童的医生已建议，但没有任何家庭尝试过迷走神经刺激术和癫痫手术。
大多数印度DRE儿童在婴儿早期发病，很少有机会接受更新的非药物治疗措施。
