难治性癫痫60例临床分析

目的明确难治性癫痫的临床特点,早期诊断难治性癫痫。方法采用回顾性病例对照分析方法对60例难治性癫痫患者的临床资料进行分析。结果与对照组相比,症状性癫痫比例、5岁之前发病率、早期频繁发作几率、出现多种癫痫发作形式和并发智能障碍几率明显增高;影像学异常改变和脑电图重度改变的几率增高;需要3种及以上药物控制发作的几率增高。结论难治性癫痫多具有如下特点:症状性癫痫、发病年龄早、病初发作频繁、出现多种发作形式、伴发或继发智能障碍、影像学异常改变、脑电图重度异常、应用多种抗癫痫药物疗效差。

Clinical Analysis of 60 patients with intractable epilepsy

Objective To explore the clinical characteristics of intractable epilepsy(IE)and try to identify the patients with IE earlier.Methods A retrospective case-control analysis of the clinical data on 60 patients with intractable epilepsy was performed.Cases were patients who had averagely four seizures or more a month over a 2- year period.Controls were patients who had epilepsy and had been seizure-free for 2 years,and who had never met the definition for intractable epilepsy.Results A comparison of intractable and well-controlled epilepsy patients showed several differences between the groups:onset<5 years of age,a high seizure frequency at onset,varieties of seizure types,cognitive function decline,abnormal brain imaging,a severe general abnormalities of EEG and failure with at least three different antiepileptic drugs were significantly more common in the study group.Symptomatic epilepsy was common in the study group than in the control group.Conclusion Several factors were strongly as- sociated with intractable epilepsy:symptomatic epilepsy,early onset,a high seizure frequency at onset,varieties of seizure types,cognitive decline,abnormal brain imaging,a severe general abnormal EEG and failure with anti- epileptic drugs.