Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA.
Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
J Clin Neurosci. 2023 Aug;114:93-96. doi: 10.1016/j.jocn.2023.06.011. Epub 2023 Jun 20.
The purpose of the current study was to investigate that which seizure type is more difficult to be brought under control with antiseizure medication treatment in patients with idiopathic generalized epilepsy (IGE).
This was a retrospective study of a large database of patients with epilepsy, which was built over more than a decade. All patients with a diagnosis of IGE, with at least 12 months of follow-up at our center, were studied at the epilepsy center at Shiraz University of Medical Sciences, Shiraz, Iran, from 2008 until 2022.
358 patients were included. The seizure types were generalized tonic-clonic seizures (GTCSs) (in 87.2%), myoclonic seizures (in 57.5%), and absence seizures (in 51.7%). Among patients who had GTCSs (N = 312), 160 patients (51.3%) became free of this seizure type. Among patients who had myoclonic seizures (N = 206), 122 patients (59.2%) became seizure-free. Among patients who had absences (N = 185), 127 patients (68.6%) became seizure-free. The difference between the groups was significant (p = 0.0007). Receiving valproate was significantly associated with a myoclonus-free status (compared with other drugs).
The likelihood of achieving seizure control is different for various seizure types in patients with IGE (achievement of seizure control is less likely for GTCSs and more likely for absences). Antiseizure drug efficacy should be considered along with other variables (e.g., sex) when selecting an ASM for a patient with IGE. Specifically designed clinical trials are needed to develop more efficacious and safe drugs to treat various syndromes of IGE.
本研究旨在探讨特发性全面性癫痫（IGE）患者中哪种癫痫发作类型更难通过抗癫痫药物治疗控制。
这是一项对超过 10 年建立的大型癫痫患者数据库进行的回顾性研究。所有在伊朗设拉子 Shiraz 大学医学科学癫痫中心被诊断为 IGE 且在本中心至少随访 12 个月的患者均纳入研究。
共纳入 358 例患者。发作类型为全面强直阵挛发作（GTCSs）（87.2%）、肌阵挛发作（57.5%）和失神发作（51.7%）。在有 GTCSs 的患者中（N=312），160 例（51.3%）患者无 GTCSs 发作。在有肌阵挛发作的患者中（N=206），122 例（59.2%）患者无发作。在有失神发作的患者中（N=185），127 例（68.6%）患者无发作。各组之间差异有统计学意义（p=0.0007）。与其他药物相比，使用丙戊酸与无肌阵挛状态显著相关。
IGE 患者的各种发作类型实现癫痫控制的可能性不同（实现 GTCSs 控制的可能性较小，而实现失神发作控制的可能性较大）。在为 IGE 患者选择抗癫痫药物时，应考虑药物疗效等其他变量。需要专门设计临床试验，以开发更有效和安全的药物来治疗 IGE 的各种综合征。
