Casetta I, Granieri E, Monetti V C, Tola M R, Paolino E, Malagù S, Gilli G, Govoni V, Carreras M
Institute of Neurological Clinic, University of Ferrara, Italy.
Neuroepidemiology. 1997;16(1):22-8. doi: 10.1159/000109667.
We performed a community-based study among children and adolescents with idiopathic and cryptogenic epilepsy and onset of the seizures between 0 and 19 years of age on the prognosis of being seizure-free. The study population was recruited during a descriptive investigation in the Local Health Service of Copparo (USL 34), Ferrara, Northern Italy. We included 111 patients (61 males and 50 females). The average length of follow-up was 18.8 years (ranging from 7 to 24 years). The cumulative probability of being in remission was 81.2% at 15 years after onset and the estimated percentage of patients in remission without therapy was 56% for the same time period. At 15 years after the onset of epilepsy, approximately 20% of patients continued to have seizures; nearly 25% continued to take antiepileptic drugs but had been free of seizures for at least 5 years; nearly 56% had been without seizures and free of medication for at least 5 years. Seizure type, gender, age at onset of the illness, epileptic abnormalities on EEG, family history of convulsive disorders, number and frequency of seizures prior to the start of treatment were found not to be helpful as prognostic factors. This community study, carried out on patients without the well known factors that adversely affect prognosis, confirms that the prospect of seizure control and for withdrawal of therapy is (generally) good.
我们对年龄在0至19岁之间、患有特发性和隐源性癫痫且癫痫发作已开始的儿童及青少年进行了一项基于社区的无癫痫发作预后研究。研究对象是在意大利北部费拉拉省科帕罗地方卫生服务局(USL 34)的一项描述性调查中招募的。我们纳入了111名患者(61名男性和50名女性)。平均随访时长为18.8年(范围从7年至24年)。发作后15年时缓解的累积概率为81.2%,同一时期未经治疗而缓解的患者估计百分比为56%。癫痫发作15年后,约20%的患者仍有发作;近25%的患者继续服用抗癫痫药物,但已无发作至少5年;近56%的患者已无发作且未用药至少5年。癫痫发作类型、性别、发病年龄、脑电图上的癫痫异常、惊厥性疾病家族史、治疗开始前的癫痫发作次数和频率,均未被发现是有用的预后因素。这项针对无已知不良预后因素患者开展的社区研究证实,癫痫发作得到控制及停药的前景(总体而言)良好。