长程脑电图监测对癫痫无发作患者停药后复发风险的预估  

Effect of long-range electroencephalogrammonitoring in predicting recurrence risk of patients with epilepsy without seizures

作　　者：王立阳 赵国祥 袁文林 孙祥喜 周学俊 WANG Liyang;ZHAO Guoxiang;YUAN Wenlin;SUN Xiangxi;ZHOU Xuejun(Department of Neurology,Fourth People's Hospital of Yancheng,Yancheng 224003,China)

机构地区：[1]盐城市第四人民医院神经内科,江苏盐城224003

出　　处：《中国实用神经疾病杂志》2018年第7期753-756,共4页Chinese Journal of Practical Nervous Diseases

基　　金：江苏省盐城市医学科技发展计划项目(YK2013038)

摘　　要：目的对癫痫无发作患者停用抗癫痫药物之前脑电图异常放电的独立风险因素进行分析,探讨通过长程脑电图监测预估癫痫无发作患者停药后复发风险的临床价值。方法对2009-01—2011-12在盐城市第四人民医院神经内科门诊经过抗癫痫药物治疗,癫痫无发作3a以上的62例原发性癫痫患者,减药、停药前行长程脑电图监测,停药后进行2~3a的随访。结果停药前有癫痫样放电患者21例,无癫痫样放电41例;有癫痫样放电患者减、停药1a内复发6例,复发率28.6%,停药后2~3a复发3例,复发率14.3%,总体复发率42.9%;无癫痫样放电患者停药后1a内复发4例,复发率9.7%,停药后2~3a复发2例,复发率4.9%,总体复发率14.6%。两者复发率差异有统计学意义(P<0.05)。结论抗癫痫药物治疗后3a以上癫痫无发作的患者不论减、停药前长程脑电图监测有无异常都有一定的癫痫复发率,而脑电图有异常放电的患者减、停药后复发率高,停药后复发风险大,长程脑电图监测对癫痫无发作患者停药后复发风险的预估有重要的临床价值。Objective To analyze the independent risk factors of abnormal EEG discharge before withdrawal of antiepileptic drugs on epileptic seizure free patients.To explore the clinical value of long term EEG monitoring in predicting the risk of recurrence after withdrawal of antiepileptic drugs in seizure free patients.Methods From January 2009 to December 2011 in the outpatient department of Neurology in our hospital,62 patients with idiopathic epilepsy who have seizure free for more than 3 years received long term EEG monitoring before drug reduction and withdrawal,followed up for 2 3 years.Results Before drug withdrawal,epileptiform discharges occurred in 21 patients,and not in 41 cases;In patients who had epileptiform discharges after drug withdrawal,6 cases had relapsed seizure within 1 year,the recurrence rate was 28.6%;3 cases have relapsed within 2 3 years,the recurrence rate was 14.3%.The overall recurrence rate was 42.9%.In patients who had no epileptiform discharges after drug withdrawal,4 cases have relapsed within 1 year,the recurrence rate was 9.7%;2 cases have relapsed within 2 3 years,the recurrence rate was 4.9%.The overall recurrence rate was 14.6%.The recurrence ratewas statistically significant.Conclusion Patients who have seizure free for more than 3 years after treatment with antiepileptic drugs have certain recurrence rateno matter what the results of long term EEG monitoring,but the recurrence rate was higher in the patients with abnormal discharges on long term EEG monitoring.Long term EEG monitoring has important clinical value in predicting the risk of recurrence after withdrawal of antiepileptic drugs in seizure free patients.

关 键 词：长程脑电图 癫痫无发作 药物平预 复发 预估 

分 类 号：R742.1[医药卫生—神经病学与精神病学]