癫(癎)患儿预后与相关因素的远期随访研究

目的 分析影响癫(癎)患儿预后的相关因素,为癫(癎)的诊治和预后评估提供依据.方法 回顾性分析2003年1-12月在北京大学第一医院儿科门诊就诊的290例癫(癎)患儿的临床资料,随访患儿发作、用药、智力及精神运动发育等情况,以至少1年无发作为疗效控制指标.结果 ①经正规抗癫(癎)药物治疗,57.9%患儿发作控制满意,多数可以正常学习或生活;(②各型癫(癎)均有控制发作的可能,不同发作类型癫(癎)的控制率不同;③起病年龄越早,特别是1岁内起病者发作控制较差;④原发性癫(癎)控制率明显高于症状性或隐源性癫(癎),症状性癫(癎)预后最差;⑤大部份病例经单药治疗可以控制发作,2种药物治疗未控制者,再添加药物进行治疗,控制率无明显提高.结论 儿童癫痫的预后大多良好,有下列情况者预后差:①起病年龄小,尤其是1岁者;②同时有多种发作形式;③症状性癫(癎).

Study on the prognosis and related factors of epilepsy in long-term follow-up children

Objectives To analyze the correlation factors,including age at onset,gender,seizure types,etiological factors and medication,which may influence the diagnosis,treatment and prognosis of epilepsy. Methods Clinical data of 290 children with epilepsy were retrospectively studied. All the children are outpatients of Peking University First Hospital. Results (1)With regular antiepileptic drug therapy,57.9% children with epilepsy can be seizure-free;(2) All seizure types or syndromes of epilepsy in children have the possibility of seizure-free,but with different rates of seizure-free between different epileptic types;(3) The younger age at onset,especially within the first year of age,the worse prognosis was;(4) The rate of seizure-free in idiopathic epilepsy is higher than that in symptomatic epilepsy and cryptogenic epilepsy. The prognosis of symptomatic epilepsy is the worst;(5)Most epileptic seizures can be controlled by mono-drug therapy. If epileptic seizure can not be controlled by combination of two drugs,the additional drug administration can hardly improve seizure-free rate. Conclusions The prognosis of epilepsy is rela- ted closely with the seizure types,etiological factors,age at onset and drug therapy. With the regular anti-epileptic drug treatment,seizures can be controlled in most pediatric patients,and most of them can go to school and have normal lives.