228例儿童癫痫停药后复发的相关因素分析

Factors Associated with Relapse after the Withdrawal of Anticonvulsant Therapy: a Study of 228 Children with Epilepsy

目的 通过对临床已获控制并停药随访的癫痫患儿复发情况的分析 ,总结并讨论与复发有关的因素。方法 回顾性分析 2 2 8例临床已获控制并停药随访的癫痫患儿的临床资料。结果 2 2 8例患儿中 51例复发(2 2 .4 % ) ,其中 92 .2 %于停药后 5年内复发。与复发相关的因素有 :起病年龄、伴有神经功能障碍、治疗前发作频率、治疗的早晚、控制期的长短及癫痫的类型 (P <0 .0 5)。与复发无关的因素有 :达控时间的长短、停药年龄、性别及癫痫家族史 (P >0 .0 5)。结论 对伴有复发危险因素的癫痫患儿应适当延长治疗和随访时间。不伴有以上相关因素的癫痫患儿 ,在经过正规的治疗和停药以后 。

Objective To evaluate the risk factors of relapse in epileptic children after the withdrawal of anticonvulsant therapy. Methods The data of 228 children with epilepsy, whose symptoms were controled and anticonvulsant therapy was withdrawn, was studied retrospectively. Results Fifty One of the 228 patients ( 22.4% ) had a recrudescence of seizures; of these, 47 ( 92.2% ) had relapse within five years of drug withdrawal. Factors associated with an increased risk of relapse were the age of onset of epilepsy, neurologic dysfunction, frequency of seizure, the duration of remission before withdrawal and the type of seizure (P< 0.05 ). There was no association between the risk factors of recrudescence and the duration of epilepsy before control, age at the discontinuation of therapy, sex and family history of epilepsy. Conclusions Patients with the risk factors should be treated and followed up longer than the others. Children who do not have the additional risk factors noted above have an excellent chance of remaining seizure free after the withdrawal of anticonvulsant drugs.