Andersson T, Braathen G, Persson A, Theorell K
Department of Clinical Neurophysiology, Karolinska Institute, Huddinge University Hospital, Sweden.
Epilepsia. 1997 Feb;38(2):225-32. doi: 10.1111/j.1528-1157.1997.tb01101.x.
We wished to evaluate the prognostic usefulness of various EEG parameters with respect to remission rates after discontinuation of antiepileptic drug (AED) therapy in children treated for epileptic seizures.
Two hundred forty-four children with uncomplicated epileptic seizures were randomized to either 1 or 3 years of treatment with AEDs. The treatment was then discontinued in patients who had been seizure-free during the last 6 months of their allotted time of treatment (n = 154). After treatment discontinuation, the children were followed for at least 2 years. EEG recordings were performed before treatment was initiated and at regular intervals during treatment.
The overall relapse rate was 37%. In many children, the amount of epileptiform activity varied considerably between subsequent recordings made during the treatment. The remission rate was slightly higher for children whose last recordings before AED discontinuation were free of epileptiform activity as compared with children in whom such activity was present. However, children who had irregular generalized spike-wave (SW) activity in the recordings made before discontinuation of treatment had a clearly higher relapse rate (67%) both as compared with children without epileptiform activity (33%) and as compared with children with other types of epileptiform activity (33%) in their last EEG recordings before discontinuation. All children treated for only 1 year whose final EEGs displayed generalized irregular SW activity relapsed.
We conclude that the presence of epileptiform activity does not in itself necessarily influence prognosis after discontinuation of treatment but that certain types of such activity signal a high risk of relapse.
我们希望评估各种脑电图参数对于接受癫痫发作治疗的儿童停用抗癫痫药物（AED）治疗后的缓解率的预后价值。
244例患有单纯性癫痫发作的儿童被随机分为接受1年或3年的AED治疗。在分配治疗时间的最后6个月内无癫痫发作的患者（n = 154）随后停止治疗。治疗停止后，对儿童进行至少2年的随访。在开始治疗前和治疗期间定期进行脑电图记录。
总体复发率为37%。在许多儿童中，治疗期间后续记录之间的癫痫样活动量差异很大。与存在此类活动的儿童相比，停用AED前最后记录无癫痫样活动的儿童缓解率略高。然而，与停用治疗前记录中无癫痫样活动的儿童（33%）以及与停用前最后脑电图记录中有其他类型癫痫样活动的儿童（33%）相比，停用治疗前记录中有不规则广泛性棘慢波（SW）活动的儿童复发率明显更高（67%）。所有仅接受1年治疗且最终脑电图显示广泛性不规则SW活动的儿童均复发。
我们得出结论，癫痫样活动的存在本身不一定会影响治疗停止后的预后，但某些类型的此类活动预示着高复发风险。
