Department of Pediatrics, Chungbuk National University Hospital, Cheongju, Republic of Korea.
Department of Pediatrics, College of Medicine, Chungbuk National University, Cheongju, Republic of Korea.
Neuropediatrics. 2024 Aug;55(4):232-240. doi: 10.1055/a-2217-0336. Epub 2023 Nov 23.
Teenagers with epilepsy require special attention to ensure a successful treatment journey. Our objective was to delineate the clinical characteristics of adolescent-onset epilepsy (AOE) and investigate the predictive factors influencing first-year seizure freedom.
We retrospectively analyzed the medical records of patients whose first seizure occurred between the ages of 10 and 19 years and who received antiseizure medication (ASM) treatment for at least 12 months.
A total of 67 patients were included, with an average age of 13.5 ± 2.3 years at the onset of their first seizure. The average follow-up period was 45.2 ± 16.9 months, and comorbid conditions were present in 23 patients (34.3%). The majority of the patient population (83.6%) was affected by generalized epilepsy. The most common epilepsy syndrome was epilepsy with generalized tonic-clonic seizures alone at 70.1% (juvenile myoclonic epilepsy 11.9%, juvenile absence epilepsy 1.5%). Regarding ASM treatment, 31 patients (46.3%) received monotherapy, and 28 (41.8%) received dual therapy. Five patients (7.5%) encountered issues related to medication adherence. First-year seizure freedom was observed in 42 patients (62.7%). In multivariate analysis, a negative family history of epilepsy (odds ratio 12.1, 95% confidence interval 1.27-115.44, = 0.030) was identified as a strong predictive factor of first-year seizure freedom, along with ASM monotherapy (odds ratio 3.99, 95% confidence interval 1.05-15.21, = 0.043).
These findings suggest that AOE typically exhibits effective control of seizures. A negative family history of epilepsy and ASM monotherapy emerges as robust predictor of achieving favorable outcomes within the early stage of treatment.
青少年癫痫患者需要特别关注，以确保治疗成功。我们的目标是描述青少年期起病癫痫（AOE）的临床特征，并研究影响第一年无发作的预测因素。
我们回顾性分析了首次发作年龄在 10 至 19 岁之间且接受抗癫痫药物（ASM）治疗至少 12 个月的患者的病历。
共纳入 67 例患者，首次发作时的平均年龄为 13.5±2.3 岁。平均随访时间为 45.2±16.9 个月，23 例（34.3%）存在合并症。大多数患者（83.6%）患有全面性癫痫。最常见的癫痫综合征是单纯全面性强直-阵挛发作的癫痫，占 70.1%（青少年肌阵挛癫痫 11.9%，青少年失神癫痫 1.5%）。ASM 治疗方面，31 例（46.3%）接受单药治疗，28 例（41.8%）接受联合治疗。有 5 例（7.5%）患者出现药物依从性问题。第一年无发作的患者有 42 例（62.7%）。多因素分析显示，癫痫阴性家族史（比值比 12.1，95%置信区间 1.27-115.44， = 0.030）和 ASM 单药治疗（比值比 3.99，95%置信区间 1.05-15.21， = 0.043）是第一年无发作的强预测因素。
这些发现表明 AOE 通常具有有效的抗癫痫作用。癫痫阴性家族史和 ASM 单药治疗是治疗早期获得良好结局的有力预测因素。
