Gerstle de Pasquet E, Bonnevaux de Toma S, Bainy J A, Bonfils E, Carvalho V, Espíndola E, Gaudiano J
Instituto de Neurología, Facultad de Medicina, Hospital de Clínicas, Montevideo, Uruguay.
Acta Neurol Latinoam. 1981;27(3-4):167-76.
In a retrospective study of 808 adult epileptic patients undertaken at the Neurological Institute of Montevideo, Uruguay, the rate of remission of seizures (three seizure-free years) was 32%, and that of relapse 39%. Remission occurred mostly during the first years after onset, and relapse during the first years after remission. Patients with generalized or partial seizures alone had a better prognosis than when both types coexisted. Patients with Petit Mal absences persisting after 14 years of age, had the lowest rate of remission. Mental status, abnormal neurological examination and age of onset showed no significant prognosis value. Remission and relapse was similar in cryptogenetic and symptomatic epilepsy. Genetic predisposition did not change the prognosis. Withdrawal of drugs after a minimal seizure-free period of three years produced a higher rate of relapse than when medication was continued. In the first EEG, only the existence of a slow background rhythm had an unfavorable prognosis. These results are compared with those of other series. It is concluded that the differing results can be attributed to a different selection of population and different methods of study. Anyway, several factors showed a similar influence on prognosis in the different series. As to indication for method of drug withdrawal after remission, and its influence on relapse, no definite conclusion can be drawn and a large, multicentric, methodical study on this topic is suggested.
在乌拉圭蒙得维的亚神经学研究所对808例成年癫痫患者进行的一项回顾性研究中，癫痫发作缓解率（三年无发作）为32%，复发率为39%。缓解大多发生在发病后的头几年，复发则发生在缓解后的头几年。单纯全身性或部分性发作的患者比两种发作类型同时存在的患者预后更好。14岁后仍有小发作失神的患者缓解率最低。精神状态、神经系统检查异常和发病年龄均无显著的预后价值。隐源性癫痫和症状性癫痫的缓解和复发情况相似。遗传易感性并未改变预后。在至少三年无发作期后停药比继续用药产生更高的复发率。在首次脑电图检查中，只有存在缓慢背景节律预后不良。将这些结果与其他系列研究的结果进行了比较。得出的结论是，不同的结果可归因于不同的人群选择和不同的研究方法。无论如何，几个因素在不同系列研究中对预后显示出相似的影响。关于缓解后停药方法的指征及其对复发的影响，无法得出明确结论，建议针对该主题开展一项大型、多中心、系统的研究。
