儿童癫痫的发病情况 - 一项多民族人群的基于人群的研究。

Landscape of childhood epilepsies - A multi-ethnic population-based study.

机构信息

Sidra Medicine, Department of Pediatrics, Division of Pediatric Neurology, Doha, Qatar.

出版信息

Epilepsy Res. 2022 Jul;183:106936. doi: 10.1016/j.eplepsyres.2022.106936. Epub 2022 Apr 28.

DOI:10.1016/j.eplepsyres.2022.106936

PMID:35526330

Abstract

OBJECTIVE

To describe the clinical features of childhood epilepsy in Qatar.

METHODS

A retrospective cross-sectional chart review analysis was conducted at the only tertiary pediatric hospital in Qatar in 1422 patients with epilepsy followed between November 2016 and October 2019.

RESULTS

55% (781) were males and 70% were non-Qatari. Age of epilepsy onset was in the neonatal period in 9% (114/1207 patients). In the non-neonatal cohort, mean age of onset was 4 yrs 9mos ( ± 1.4mos). Focal epilepsy was the predominant epilepsy type in 45% (594/1314 patients) versus generalized epilepsy in 37% and combined focal/generalized epilepsy in 12%. Etiology was unknown in most children (782/1363, 57%) whereas structural and genetic causes represented 23% and 11% of cases respectively. No differences in epilepsy type and etiology were found between different ethnic groups. Children with genetic or structural epilepsies had an earlier epilepsy onset compared to those with unknown etiologies. At the last follow up, only 36% of patients were seizure-free and 12% (170/1422) had a history of status epilepticus. Medically refractory epilepsy was found in 37% (527/1407) of patients, with the most common etiologies being unknown (36%) and structural (37%). Neurodevelopmental co-morbidities were present in most patients (62%), with global developmental delay (47%) and learning/school difficulties (22%) being the most prevalent. 94% of patients with somatic co-morbidities had concomitant neurodevelopmental co-morbidities. Risk factors associated with an increased risk of co-morbidities and intractable epilepsy included early age of epilepsy onset (< 2 years of age); etiology; antenatal risk factors; history of previous central nervous system infection; history of status epilepticus and a family history of consanguinity and epilepsy.

SIGNIFICANCE

This large multi-ethnic population-based study confirms that the prevalence, incidence and clinical features of epilepsy in Qatar is in accordance with other epidemiologic studies and highlights risk factors for the development of co-morbidities and medically-intractable epilepsy.

摘要

目的

描述卡塔尔儿童癫痫的临床特征。

方法

对卡塔尔唯一的一家三级儿科医院在 2016 年 11 月至 2019 年 10 月间随访的 1422 例癫痫患者进行回顾性横断面图表分析。

结果

55%（781 例）为男性，70%是非卡塔尔人。9%（114/1207 例）的癫痫发病年龄在新生儿期。在非新生儿组中，发病年龄的平均值为 4 岁 9 个月（±1.4 个月）。局灶性癫痫是最常见的癫痫类型，占 45%（594/1314 例），其次是全面性癫痫占 37%，局灶性/全面性癫痫占 12%。大多数儿童病因不明（782/1363，57%），而结构和遗传原因分别占 23%和 11%。不同种族之间的癫痫类型和病因无差异。有遗传或结构性癫痫的儿童比病因不明的儿童癫痫发病更早。最后一次随访时，仅有 36%的患者无癫痫发作，12%（170/1422）有癫痫持续状态病史。37%（527/1407）的患者为药物难治性癫痫，最常见的病因是病因不明（36%）和结构性（37%）。大多数患者存在神经发育共病（62%），最常见的是全面发育迟缓（47%）和学习/学校困难（22%）。94%的有躯体共病的患者同时存在神经发育共病。与共病和耐药性癫痫风险增加相关的危险因素包括癫痫发病年龄较早（<2 岁）；病因；产前危险因素；既往中枢神经系统感染史；癫痫持续状态史；以及近亲结婚和癫痫家族史。