论文部分内容阅读
描述新诊断的症状性局灶性癫痫(Symptomatic focalepilepsies,FS)和可疑症状性局灶性癫痫(Presumed symptomatic focalepilepsies,FCE)患儿入组时及入组后1个月以内的临床、神经心理学和心理病理学特征。将对这些患者入组后随访2~5年,以探究癫痫的病程和药物难治性癫痫的早期预测因素。在这个观察性的多中心全国性研究中,新诊断的FS或者FCE儿童(年龄1个月~12.9岁)在15个意大利儿童癫痫高级研究中心被连续纳入。纳入标准如下:(1)后天或发育因素导致的FS,以及FCE;(2)首次诊断为癫痫的年龄>1个月并且<13岁;(3)签署书面的知情同意书。临床、脑电图、神经影像以及神经心理资料都用于统计分析。最终纳入259例儿童(女116例,男143例)。年龄中位数为4.4岁(范围:1个月~12.9岁),46.0%(n=119)≤3岁,24%(n=61)>3~6岁,30%(n=79)>6岁。71.8%的患儿神经系统检查正常。59.9%头部核磁共振(MRI)检查异常。年龄≤3岁组的患儿入组后第一个月发作的频率最高(P<0.000 1)。67.2%的患儿第一个月为单药治疗。在基线期,30%的患儿认知功能检查异常;21%存在行为问题。多因素分析发现,年幼儿和颞叶癫痫患儿起病后第一个月内发作频率>5次的几率更大。该项前瞻性的队列研究发现,儿童期起病的FS和FCE患者的许多特征与起病的年龄以及致痫灶的部位有关。
Describe the clinical and neuropsychological findings of newly diagnosed symptomatic focalepilepsies (FS) and presumptive symptomatic focalepilepsies (FCE) at enrollment and within 1 month of enrollment And psychopathological features. These patients will be followed up for 2 to 5 years after enrollment to explore the course of epilepsy and the early predictors of drug refractory epilepsy. In this observational, multicentre, nationwide study, newly diagnosed FS or FCE children (age 1 month to 12.9 years) were included in succession at the Center for Advanced Epilepsy in 15 Italian Children. Inclusion criteria were as follows: (1) Acquired or Developmental-induced FS, and FCE; (2) Age> 1 month and <13 years of initial diagnosis of epilepsy; (3) Signing written informed consent. Clinical, EEG, neuroimaging, and neuropsychological data were used for statistical analysis. Finally, 259 children (116 female and 143 male) were included. The median age was 4.4 years (range: 1 month to 12.9 years), 46.0% (n = 119) ≤3 years, 24% (n = 61) 6 years old. 71.8% of children with normal neurological examination. 59.9% Head MRI abnormalities. Children aged <3 years had the highest frequency of attacks in the first month after admission (P <0.000 1). 67.2% of the children in the first month as monotherapy. At baseline, 30% of children had abnormal cognitive function tests; 21% had behavioral problems. Multivariate analysis found that infants and children with temporal lobe epilepsy in the first month after onset onset frequency of> 5 times more likely. This prospective cohort study found that many of the characteristics of patients with childhood onset FS and FCE are related to the age of onset and the site of the epileptogenic focus.