Salinas-Salvador B, Moreno-Sánchez A, Carmen-Marcén G, Molina-Herranz D, Lafuente-Hidalgo M, López-Pisón J
HUMS. Hospital Universitario Miguel Servet, 50009 Zaragoza, España.
Rev Neurol. 2023 Feb 1;76(3):83-89. doi: 10.33588/rn.7603.2022184.
Pharmacological treatment of epilepsy is not healing; it tries to avoid seizures, as far as possible, in children who probably would still have them.
Our purpose is to analyse our experience with epileptic children and those who have a first non-symptomatic seizure without pharmacological treatment. Patients seen in a paediatric neurology consultation, from 2017 to 2021, who had suffered one or more acute non-symptomatic crises and who had not been treated pharmacologically, were analysed.
Sixty-five patients meet the selection criteria. Twenty-four patients had had a single crisis with a mean duration of 12 minutes (1-60). In 66.7% it was nocturnal. 41.7% presented pathological electroencephalogram, and 21% pathological findings in neuroimaging. The mean control time was 2.7 years (0.003-13.6 years). Forty-one presented more than one crisis, with a mean duration of nine minutes (1-60). Five patients presented more than 20 seizures, the rest between two and 17. Twenty-four (58.5%) presented only nocturnal seizures. An electroencephalogram was performed in all: epileptiform graphoelements in 63.4%; and neuroimaging in all: pathological in 4.9%. Mean control time was 3.8 years (0.01-9.1 years).
Seizure frequency, underlying pathology or test results should not be the only variables to take into consideration when starting antiepileptic drug treatment. The repercussion on their quality of life and neurodevelopment should prevail, agreeing on this decision with the parents.
癫痫的药物治疗并非治愈；它旨在尽可能避免可能仍会发作的儿童出现癫痫发作。
我们的目的是分析我们对癫痫儿童以及首次出现非症状性癫痫发作且未接受药物治疗的儿童的经验。对2017年至2021年在儿科神经科门诊就诊、经历过一次或多次急性非症状性发作且未接受药物治疗的患者进行分析。
65名患者符合入选标准。24名患者仅有一次发作，平均持续时间为12分钟（1 - 60分钟）。其中66.7%为夜间发作。41.7%的患者脑电图异常，21%的患者神经影像学检查有异常发现。平均控制时间为2.7年（0.003 - 13.6年）。41名患者发作不止一次，平均持续时间为9分钟（1 - 60分钟）。5名患者发作超过20次，其余患者发作2至17次。24名（58.5%）患者仅在夜间发作。所有患者均进行了脑电图检查：63.4%有癫痫样波形成分；所有患者均进行了神经影像学检查：4.9%有异常。平均控制时间为3.8年（0.01 - 9.1年）。
在开始抗癫痫药物治疗时，癫痫发作频率、潜在病理或检查结果不应是唯一需要考虑的变量。应优先考虑对其生活质量和神经发育的影响，并与家长就这一决定达成一致。
