Kim Hyun-Jin, Jang Han Na, Ahn Hyunji, Yum Mi-Sun, Ko Tae-Sung
Department of Pediatrics, Myongji Hospital, Goyang 10475, Korea.
Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea.
J Clin Med. 2021 Jan 22;10(3):430. doi: 10.3390/jcm10030430.
Seizures in infancy have highly variable courses and underlying etiologies. However, there are only a few long-term follow-up studies regarding infantile-onset epilepsy. Therefore, we aimed to describe the clinical courses, seizure outcomes, and risk factors of infantile-onset epilepsy followed up for more than 10 years in a tertiary center.
Data of the patients with epilepsy, diagnosed under the age of 12 months and followed up for more than 10 years, were retrieved from the electronic medical records of Asan Medical Center Children's Hospital. The patients' medical records were retrospectively reviewed, and clinical outcomes were assessed based on the duration of seizure freedom at the last follow-up.
Of the 146 patients, 103 (70.5%) entered at least one remission, of whom epilepsy was resolved in 46 (31.5%). Forty-nine (33.6%) were found to be intractable at last contact. Delayed development, neurological deficits, and later onset (>3 months) were significantly associated with intractable epilepsies ( < 0.01).
This study demonstrated that many patients with infantile-onset epilepsy can experience seizure remission. However, in some cases, early onset epilepsy was highly associated with various comorbidities and intractable seizures. Therefore, appropriate diagnosis and treatment are necessary to prevent further neuropsychiatric complications.
婴儿期癫痫发作的病程和潜在病因具有高度变异性。然而,关于婴儿期起病癫痫的长期随访研究却很少。因此,我们旨在描述在一家三级医疗中心随访超过10年的婴儿期起病癫痫的临床病程、癫痫发作结局及危险因素。
从峨山医疗中心儿童医院的电子病历中检索出12个月龄前诊断为癫痫且随访超过10年的患者数据。对患者病历进行回顾性分析,并根据末次随访时无癫痫发作的持续时间评估临床结局。
146例患者中,103例(70.5%)至少进入一次缓解期,其中46例(31.5%)癫痫得到缓解。在末次随访时,49例(33.6%)被发现为难治性癫痫。发育迟缓、神经功能缺损及起病较晚(>3个月)与难治性癫痫显著相关(<0.01)。
本研究表明,许多婴儿期起病癫痫患者可出现癫痫发作缓解。然而,在某些情况下,早发性癫痫与多种合并症及难治性癫痫发作高度相关。因此,需要进行恰当的诊断和治疗以预防进一步的神经精神并发症。