目的:对癫痫患者单药正规治疗3年且无临床发作停药后复发的相关因素进行分析。方法:选择自2010年1月-2014年1月本院神经内科收治癫痫患者100例,入选患者行单药正规治疗3年且无临床发作。停药前24 h VEEG痫性放电≤5次/24 h。随访符合要...目的:对癫痫患者单药正规治疗3年且无临床发作停药后复发的相关因素进行分析。方法:选择自2010年1月-2014年1月本院神经内科收治癫痫患者100例,入选患者行单药正规治疗3年且无临床发作。停药前24 h VEEG痫性放电≤5次/24 h。随访符合要求患者1年,若发生复发则随访停止。比较分析患者年龄、性别、停药前24h VEEG、影像检查中颅内病灶的有无,癫痫发作类型、频率以及形式,以及治疗方案,治疗时间等因素。结果:最终70例患者进行最后统计分析,24例患者在1年随访期内有复发(31.2%),性别、年龄、停药处理前脑电图形式、癫痫发作类型、用药方案、是否存在癫痫持续状态这几项内容的比较差异无统计学意义(P>0.05),停药前发作形式(P=0.014)、影像检查颅内病灶的有无(P=0.021)、开始治疗前癫痫发作频率的大小(P=0.035)、以及开始治疗前病程长短(P=0.006)四项内容具有统计学差异。41.7%患者无明显诱因即癫痫复发,而长时间玩电脑、休息不足以及饮酒等不良生活方式在复发诱因中占比37.5%,感染的发生占癫痫复发诱因的16.7%。结论:对单药正规治疗3年且无临床发作的癫痫患者停药处理后,仍存在高危因素导致其癫痫复发,对这些高危因素的明确在对癫痫患者的停药处理中具有指导作用,对其停药后癫痫复发的减少有显著帮助。展开更多
The optimum control of seizures requires adequate dosing of appropriately selected anti-epileptic medications. The availability of AEDs in Nigeria is limited and this constrains the prescription latitude of clinicians...The optimum control of seizures requires adequate dosing of appropriately selected anti-epileptic medications. The availability of AEDs in Nigeria is limited and this constrains the prescription latitude of clinicians. This study was conducted to describe the prescribing pattern of anti-epileptic drugs in the outpatient service of a psychiatric facility in southeast Nigeria. The case records of the epileptic patients attending the outpatient clinic of a psychiatric hospital were retrieved, reviewed and data abstracted with a prepared proforma. The information extracted include age, sex, marital status, residence, type of seizure and anti-seizure medications prescribed, frequency of administration and dosage among other variables. Of the 178 patients whose prescriptions and case records were assessed, males constituted 62.9% and females 37.1%. Most of the patients were single (78.1%) and the group had a mean age of 25.6 ± 10.9 years. Generalized tonic-clonic seizures predominated (61.2%) among the seizure types, whilst complex partial seizure type was identified in 35.4% of the patients. Patient diagnosis relied heavily on the use of clinical description alone. About 92.7% of the patients were treated with monotherapy, whereas 7.3% received two anti-epileptic drug combinations. Carbamazepine was the most frequently prescribed drug, and was utilized in the treatment of 87.9% of patients receiving monotherapy and 92.3% of individuals receiving two drug combinations. Adjunctive medications like benzodiazepines were rarely utilised to improve the effect of the AEDs. The patients that received polytherapy could only be distinguished from those that received monotherapy by higher frequency of epileptic auras and higher mean dose of AEDs per day. The predominant use of monotherapy is in accordance with the treatment recommendations and needs to be encouraged. The greater use of carbamazepine is probably related to its perceived benefits in the control of behavioural symptoms.展开更多
文摘目的:对癫痫患者单药正规治疗3年且无临床发作停药后复发的相关因素进行分析。方法:选择自2010年1月-2014年1月本院神经内科收治癫痫患者100例,入选患者行单药正规治疗3年且无临床发作。停药前24 h VEEG痫性放电≤5次/24 h。随访符合要求患者1年,若发生复发则随访停止。比较分析患者年龄、性别、停药前24h VEEG、影像检查中颅内病灶的有无,癫痫发作类型、频率以及形式,以及治疗方案,治疗时间等因素。结果:最终70例患者进行最后统计分析,24例患者在1年随访期内有复发(31.2%),性别、年龄、停药处理前脑电图形式、癫痫发作类型、用药方案、是否存在癫痫持续状态这几项内容的比较差异无统计学意义(P>0.05),停药前发作形式(P=0.014)、影像检查颅内病灶的有无(P=0.021)、开始治疗前癫痫发作频率的大小(P=0.035)、以及开始治疗前病程长短(P=0.006)四项内容具有统计学差异。41.7%患者无明显诱因即癫痫复发,而长时间玩电脑、休息不足以及饮酒等不良生活方式在复发诱因中占比37.5%,感染的发生占癫痫复发诱因的16.7%。结论:对单药正规治疗3年且无临床发作的癫痫患者停药处理后,仍存在高危因素导致其癫痫复发,对这些高危因素的明确在对癫痫患者的停药处理中具有指导作用,对其停药后癫痫复发的减少有显著帮助。
文摘The optimum control of seizures requires adequate dosing of appropriately selected anti-epileptic medications. The availability of AEDs in Nigeria is limited and this constrains the prescription latitude of clinicians. This study was conducted to describe the prescribing pattern of anti-epileptic drugs in the outpatient service of a psychiatric facility in southeast Nigeria. The case records of the epileptic patients attending the outpatient clinic of a psychiatric hospital were retrieved, reviewed and data abstracted with a prepared proforma. The information extracted include age, sex, marital status, residence, type of seizure and anti-seizure medications prescribed, frequency of administration and dosage among other variables. Of the 178 patients whose prescriptions and case records were assessed, males constituted 62.9% and females 37.1%. Most of the patients were single (78.1%) and the group had a mean age of 25.6 ± 10.9 years. Generalized tonic-clonic seizures predominated (61.2%) among the seizure types, whilst complex partial seizure type was identified in 35.4% of the patients. Patient diagnosis relied heavily on the use of clinical description alone. About 92.7% of the patients were treated with monotherapy, whereas 7.3% received two anti-epileptic drug combinations. Carbamazepine was the most frequently prescribed drug, and was utilized in the treatment of 87.9% of patients receiving monotherapy and 92.3% of individuals receiving two drug combinations. Adjunctive medications like benzodiazepines were rarely utilised to improve the effect of the AEDs. The patients that received polytherapy could only be distinguished from those that received monotherapy by higher frequency of epileptic auras and higher mean dose of AEDs per day. The predominant use of monotherapy is in accordance with the treatment recommendations and needs to be encouraged. The greater use of carbamazepine is probably related to its perceived benefits in the control of behavioural symptoms.
