抗癫痫药物或非药物治疗反射性癫痫伴异常脑电图的临床观察

Comparative study of reflex epilepsy with abnormal EEG by antiepileptic drugs or non-medicine treatment

目的i比较抗癫痫药物或非药物治疗反射性癫痫的临床疗效和脑电图改变。方法i将27例患者分为3组：第1组为反射性癫痫伴脑电图异常（痫样放电1～4次／24h），未用抗癫痫药者；第2组：反射性癫痫伴脑电图异常（痫样放电1～4次／24h），使用抗癫痫药者；第3组为反射性癫痫伴脑电图异常（痫样放电≥5次／24h），使用抗癫痫药者。各组均需避开诱因。根据患者既往最长癫痫发作间期的3倍时间随访其癫痫发作次数和视频脑电图表现。结果：各组无1例临床加重患者，临床总有效率为63％～100％，各组之间比较差异无统计学意义。脑电图改善总有效率3个组之间有明显差异（P〈0．05）。脑电图异常（痫样放电1～4次／24h）病人用药与否脑电图改善总有效率比较差异有显著意义（P〈0．01）。结论：各组反射性癫痫预后良好，伴脑电图异常的反射性癫痫建议给予抗癫痫药治疗。

Objective：To fulfill a comparative study of the clinical curative effect and electroencephalogram （EEG） of reflex epilepsy by antiepileptic drugs（AEDs） or non-medicine treatment. Methods： 27 patients with reflex epilepsy were divided into 3 groups. Group 1 ： Of abnormal EEG （epileptiform discharges 1 - 4 times/ 24 h） without medicine treatment;Group 2：Of abnormal EEG （epileptiform discharges 1 -4 times/24 h） with AEDs treatment ; Group 3：Of abnormal EEG （epileptiform discharges≥5 times /24 h） with AEDs treatment. All patients avoided precipitating factors. The frequency of epileptic seizures within 3 times as the longest seizure were evaluated during the inter-ictal phase treatment and their V-EEG. Results： No one exacerbated clinical sei- zure. The total clinical effective rate was 62.5 % - 100% and had no statistical difference. The EEG effective rate had obvious statistical difference among 3 groups（P〈0. 05）. And there was significant statistical difference between Non-medicine groups and AEDs groups with abnormal EEG （epileptiform discharges 1-4 times/24 h） （P〈0.01）. Conclusion： The prognosis of reflex epilepsy in each group is desirable. Reflex epileptic palients with abnormal EEG should be recommended AEDs treatment.