Department of Children's Diseases, Kazakhstan's Medical University, School of Public Health (KSPH), Almaty, Kazakhstan.
Department of Medical Imaging, Neuroradiology, Banner University Medical Center, Tucson, AZ, USA.
J Int Med Res. 2021 Aug;49(8):3000605211039805. doi: 10.1177/03000605211039805.
To estimate anti-seizure medication (ASM) treatment burden and its effects on health-related quality of life (HRQOL) in new-onset childhood epilepsy with centrotemporal spikes (CECTS) using different treatment approaches in Kazakhstan.
Forty-three patients were followed prospectively during 2015 to 2020 for at least 2 years. Patients were divided into three groups: (1) history of ≤3 seizures (n = 32); (2) ≥4 seizures (n = 6); (3) cerebral palsy coexisting with CECTS (n = 5). The first group was subdivided into treated (n = 8) and observed (n = 24) subgroups. The shortened Quality of Life in Childhood Epilepsy Questionnaire (QOLCE-55) was completed by parents after 6 months of follow-up.
At the end of the study, all children had a sustained remission from seizures for at least 2 years. Differences were identified in emotional, social, and physical subscales between patients in the low seizure frequency group. Signs of low self-esteem, anxiety, depression, limited social interaction owing to pharmacotherapy, painful medical procedures, and stigma were reasons for decreased HRQOL in the treated subgroup. Overall HRQOL in treated (89.2 ± 5.2) patients was significantly decreased compared with observed children with low seizure frequency (98.0 ± 3.0).
ASM therapy does not necessarily improve and may decrease HRQOL in children with low seizure frequency CECTS.
使用不同的治疗方法在哈萨克斯坦估计新诊断的伴中央颞区棘波的儿童癫痫(CECTS)的抗癫痫药物(ASM)治疗负担及其对健康相关生活质量(HRQOL)的影响。
43 例患者在 2015 年至 2020 年期间进行了至少 2 年的前瞻性随访。患者分为三组:(1)≤3 次发作史(n=32);(2)≥4 次发作(n=6);(3)伴 CECTS 的脑瘫(n=5)。第一组进一步分为治疗组(n=8)和观察组(n=24)。在随访 6 个月后,由家长完成简化儿童癫痫生活质量问卷(QOLCE-55)。
研究结束时,所有儿童的癫痫发作均持续缓解至少 2 年。在低发作频率组患者中,情绪、社会和身体亚量表之间存在差异。自尊心低下、焦虑、抑郁、药物治疗引起的社交受限、痛苦的医疗程序和污名化是治疗亚组 HRQOL 下降的原因。与低发作频率观察组(98.0±3.0)相比,治疗组(89.2±5.2)患者的整体 HRQOL 显著下降。
ASM 治疗不一定会改善低发作频率 CECTS 儿童的 HRQOL,并且可能会降低其 HRQOL。