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首页> 外文期刊>The Canadian Journal of Neurological Sciences: le Journal Canadien des Sciences Neurologiques >Predictors of unfavourable seizure outcome in patients with epilepsy in Nepal.
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Predictors of unfavourable seizure outcome in patients with epilepsy in Nepal.

机译：尼泊尔癫痫患者癫痫预后不良的预测因素。

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BACKGROUND: Despite optimal medical therapy, a sizeable number of patients continue to have persistent seizures. We evaluated the association of pretreatment and treatment variables with unfavorable seizure outcome. METHODS: Patients with follow-up over 12 years in the Nepal Epilepsy Association were evaluated. Patients having seizures for at least a year and already on polytherapy after failure of two monotherapy trials were considered having unfavourable outcome. Variables under study were: age, sex, duration and frequency of seizures prior to treatment, type of seizure, neurological status, Computed Tomography (CT) finding, and failure of first anti-epileptic drug (AED). Bivariate analysis was done with Chi-square and Fisher exact tests. Potential interaction between variables was studied with a logistic regression analysis. RESULTS: Out of a total 529 consecutive patients, 490 were included in the study. Unfavorable seizure outcome was seen in 26.8% of patients. Among 284 patients who remained viable for analysis, bivariate analysis showed significant association of unfavorable outcome with frequency of seizure (p 0.01), abnormal neurological status (p 0.01) and failure of first AED (p 0.00), while no significant association was seen with age at onset (p 0.45), sex (p 0.47), duration of seizure (p 0.43), type of seizure (p 0.12), and presence of CT abnormality (p 0.46). The fitted regression model portended an unfavorable prognosis with failure of first AED and abnormal neurological status, however, failed to show significant association with frequency of seizure. CONCLUSIONS: Failure of first AED trial and associated neurological deficits are significant predictors of unfavorable seizure outcome.
机译：背景：尽管有最佳的药物治疗方法，但仍有大量患者持续发作。我们评估了预处理和治疗变量与不良癫痫预后的关系。方法：对尼泊尔癫痫协会进行了12年以上随访的患者进行了评估。癫痫发作至少一年且在两项单药治疗试验失败后已经接受多药治疗的患者被认为具有不良预后。研究的变量包括：年龄，性别，治疗前癫痫发作的持续时间和频率，癫痫发作的类型，神经系统状况，计算机断层扫描（CT）的发现以及第一种抗癫痫药（AED）的失败。采用卡方检验和Fisher精确检验进行双变量分析。变量之间的潜在相互作用进行了逻辑回归分析。结果：在总共529名患者中，有490名被纳入研究。在26.8％的患者中发现了癫痫发作的不良结果。在284例仍可进行分析的患者中，双变量分析显示不良结局与癫痫发作频率（p 0.01），神经系统异常（p 0.01）和首次AED失败（p 0.00）显着相关，而与发病年龄（p 0.45），性别（p 0.47），癫痫发作持续时间（p 0.43），癫痫发作类型（p 0.12）和是否存在CT异常（p 0.46）。拟合回归模型预示了首次AED失败和神经系统状态异常的不良预后，但是未显示与癫痫发作频率显着相关。结论：首次AED试验失败和相关的神经功能缺损是癫痫预后不良的重要预测指标。

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