儿童癫痫的 50 年随访研究：医疗结局、发病率和药物治疗_Journal of Epilepsy

Authors：

 BrorsonLars-Olov , ErikssonMats , BlombergKarin , 覃英杰　译 , 慕洁　审

Corresponding author：

BrorsonLars-Olov, Email: eric.stenninger@regionorebrolan.se

Keywords：

死亡原因; 长期随访; 药物治疗; 死亡率; 复发; 癫痫发作

DOI：

10.7507/2096-0247.20200087

Video：

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描述儿童癫痫的长期预后，尤其侧重于癫痫发作缓解、复发、药物治疗、相关神经系统功能障碍、死亡率和死亡原因。针对 1962 年—1964 年间基于人群总数为 195 例癫痫发作儿童队列的一项前瞻性纵向研究。数据均通过医疗记录和调查问卷收集。来自最初队列 94% 的随访数据显示，无智力或神经功能障碍的患儿，无癫痫发作的长期预后最好。这些患儿发病较晚，癫痫发作的持续时间较短，且通常不使用药物。他们中仅少数曾复发。全面性而非局灶性癫痫，通常较少复发，持续用药更短。 “真正发病”组，即在 1962 年—1964 年间纳入的发病患儿，无癫痫发作的长期预后最好，90% 在 50 年后癫痫无发作。尽管该组中仅 10% 在随访时仍有发作，但 22% 仍使用抗惊厥药物，且常使用传统药物—苯巴比妥或苯妥英钠作为抗癫痫药物之一。整个组的标准化死亡率（Standardized mortality ratio，SMR）为 2.61，且在有无其他神经系统缺陷的患者之间无差异。年轻的死亡患者部分有神经系统损伤，部分死于癫痫相关的情况，而年龄较大的患者死亡通常由非癫痫相关疾病导致。发病组中无患者死于癫痫猝死（Sudden unexpected death in epilepsy，SUDEP）。我们 12 年的随访和以往的报道相比，儿童癫痫患者的 50 年长期随访总体显示出更好的癫痫无发作结局。文章报道了癫痫发作较低的复发率，癫痫发作的缓解并不意味着药物治疗的终止，SUDEP 相关的死亡率也低于以往的报道。

Citation： BrorsonLars-Olov, ErikssonMats, BlombergKarin, 覃英杰　译, 慕洁　审. 儿童癫痫的 50 年随访研究：医疗结局、发病率和药物治疗. Journal of Epilepsy, 2020, 6(6): 528-536. doi: 10.7507/2096-0247.20200087 Copy

1.	Brorson LO. Epilepsi hos barn och ungdom: en klinisk, psyko- metrisk och social undersökning inom Uppsala län [Epilepsy in children and adolescents: a clinical, psychometric and social investigation within Uppsala County]. In: Brorson L-O, editor Epileptikervården: integrering med övrig hälso- och sjukvård [Caring for epilepsy patients: integration with other health care]. Socialstyrelsen redovisar 0346-5799; 12th ed. Stockholm, Swe- den: Socialstyrelsen, 1969.
2.	Sillanpää M. Medico-social prognosis of children with epilepsy. Turku, Finland: University of Turku, 1973.
3.	Beghi E, Camfield P, Camfield C. Epidemiological aspects: lost in transition. Epilepsia, 2014, 55(Suppl 3): 3-7.
4.	Brorson LO, Wranne L. Long‐term prognosis in childhood epi- lepsy: survival and seizure prognosis. Epilepsia, 1987, 28(4): 324-330.
5.	Sillanpää M, Schmidt D, Saarinen MM, et al. Remission in epi- lepsy: how long is enough? Epilepsia, 2017, 58(5): 901-906.
6.	Sillanpaa M, Schmidt D. Natural history of treated childhood‐ onset epilepsy: prospective, long‐term population‐based study. Brain, 2006, 129(Pt 3): 617-624.
7.	Sillanpaa M, Anttinen A, Rinne JO, et al. Childhood‐onset epi- lepsy five decades later. A prospective population‐based cohort study. Epilepsia, 2015, 56(11): 1774-1783.
8.	Sillanpaa M, Schmidt D. Long‐term employment of adults with childhood‐onset epilepsy: a prospective population‐based study. Epilepsia, 2010, 51(6): 1053-1060.
9.	Sillanpää M, Shinnar S. Long‐term mortality in childhood‐onset epilepsy. N Engl J Med, 2010, 363(26): 2522-2529.
10.	Sillanpaa M, Saarinen M, Schmidt D. Long‐term risks following first remission in childhood‐onset epilepsy. A population‐based study. Epilepsy Behav, 202, 25(2): 145-149.
11.	Sillanpaa M, Shinnar S. SUDEP and other causes of mortality in childhood‐onset epilepsy. Epilepsy Behav, 2013, 28(2): 249-255.
12.	Sillanpaa M, Saarinen M, Schmidt D. Clinical conditions of long‐ term cure in childhood‐onset epilepsy: a 45‐year follow‐up study. Epilepsy Behav, 2014, 37(1): 49-53.
13.	Novy J, Belluzzo M, Caboclo LO, et al. The lifelong course of chronic epilepsy: the Chalfont experience. Brain, 2013, 136(Pt 10): 3187-3199.
14.	Chin RFM, Cumberland PM, Pujar SS, et al. Outcomes of child- hood epilepsy at age 33 years. Epilepsia, 2011, 52(8): 1513-1521.
15.	Scheffer IE, Berkovic S, Capovilla G, et al. ILAE classification of the epilepsies: position paper of the ILAE Commission for Classification and Terminology. Epilepsia, 2017, 58(4): 512-521.
16.	Camfield P, Camfield C. Long‐term Prognosis for symptomatic (secondary) generalized Epilepsies: a population based study. Epilepsia, 2007, 48(6): 1128-1132.
17.	Camfield P, Camfield C. Idiopathic generalized epilepsy with generalized tonic‐clonic siezures (IGE‐GTC): a population‐based cohort with >20 year follow up for medical and social outcome. Epilepsy Behav, 2010, 18(1-2): 61-63.

1. Brorson LO. Epilepsi hos barn och ungdom: en klinisk, psyko- metrisk och social undersökning inom Uppsala län [Epilepsy in children and adolescents: a clinical, psychometric and social investigation within Uppsala County]. In: Brorson L-O, editor Epileptikervården: integrering med övrig hälso- och sjukvård [Caring for epilepsy patients: integration with other health care]. Socialstyrelsen redovisar 0346-5799; 12th ed. Stockholm, Swe- den: Socialstyrelsen, 1969.
2. Sillanpää M. Medico-social prognosis of children with epilepsy. Turku, Finland: University of Turku, 1973.
3. Beghi E, Camfield P, Camfield C. Epidemiological aspects: lost in transition. Epilepsia, 2014, 55(Suppl 3): 3-7.
4. Brorson LO, Wranne L. Long‐term prognosis in childhood epi- lepsy: survival and seizure prognosis. Epilepsia, 1987, 28(4): 324-330.
5. Sillanpää M, Schmidt D, Saarinen MM, et al. Remission in epi- lepsy: how long is enough? Epilepsia, 2017, 58(5): 901-906.
6. Sillanpaa M, Schmidt D. Natural history of treated childhood‐ onset epilepsy: prospective, long‐term population‐based study. Brain, 2006, 129(Pt 3): 617-624.
7. Sillanpaa M, Anttinen A, Rinne JO, et al. Childhood‐onset epi- lepsy five decades later. A prospective population‐based cohort study. Epilepsia, 2015, 56(11): 1774-1783.
8. Sillanpaa M, Schmidt D. Long‐term employment of adults with childhood‐onset epilepsy: a prospective population‐based study. Epilepsia, 2010, 51(6): 1053-1060.
9. Sillanpää M, Shinnar S. Long‐term mortality in childhood‐onset epilepsy. N Engl J Med, 2010, 363(26): 2522-2529.
10. Sillanpaa M, Saarinen M, Schmidt D. Long‐term risks following first remission in childhood‐onset epilepsy. A population‐based study. Epilepsy Behav, 202, 25(2): 145-149.
11. Sillanpaa M, Shinnar S. SUDEP and other causes of mortality in childhood‐onset epilepsy. Epilepsy Behav, 2013, 28(2): 249-255.
12. Sillanpaa M, Saarinen M, Schmidt D. Clinical conditions of long‐ term cure in childhood‐onset epilepsy: a 45‐year follow‐up study. Epilepsy Behav, 2014, 37(1): 49-53.
13. Novy J, Belluzzo M, Caboclo LO, et al. The lifelong course of chronic epilepsy: the Chalfont experience. Brain, 2013, 136(Pt 10): 3187-3199.
14. Chin RFM, Cumberland PM, Pujar SS, et al. Outcomes of child- hood epilepsy at age 33 years. Epilepsia, 2011, 52(8): 1513-1521.
15. Scheffer IE, Berkovic S, Capovilla G, et al. ILAE classification of the epilepsies: position paper of the ILAE Commission for Classification and Terminology. Epilepsia, 2017, 58(4): 512-521.
16. Camfield P, Camfield C. Long‐term Prognosis for symptomatic (secondary) generalized Epilepsies: a population based study. Epilepsia, 2007, 48(6): 1128-1132.
17. Camfield P, Camfield C. Idiopathic generalized epilepsy with generalized tonic‐clonic siezures (IGE‐GTC): a population‐based cohort with >20 year follow up for medical and social outcome. Epilepsy Behav, 2010, 18(1-2): 61-63.

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Journal of Epilepsy

儿童癫痫的 50 年随访研究：医疗结局、发病率和药物治疗

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