Postencephalitic Epilepsy: Experience From Southwest China

Background Viral encephalitis may cause potentially devastating sequelae, including post-encephalitic epilepsy (PEE) and refractory epilepsy. The purpose of this study was to analyze the efficacy and safety of several antiepileptic drugs (AEDs) in PEE.Methods A cohort of patients diagnosed with PEE related to presumed encephalitis was retrospectively studied. Patients were divided into different antiepileptic drug groups. Retention rates, 50% responder rates, remission rates and adverse events were evaluated. Several risk factors for adverse events were assessed, including gender, age and drug choice.Findings Two hundred and ninety-two patients were enrolled in this study. PEE manifestations occurred mainly in children and teenagers and occurred rarely in older adults. SGTCS was the frequent type in PEE patients. CBZ had significant higher retention rate than VPA-Mg and Combined therapy in the first year. Combined therapies of AEDs had lower retention rate. The data from the first years suggested PB elicited a good response for PEE patients. VPA-Mg, VPA-Na and TPM had good efficacy, based on 50% responder rates and remission rates. PHT had the highest incidence of both moderate and serious adverse effects among the six drugs studied.Conclusion Considering the retention rates, remission rates, 50% responder rates and adverse effects together, we suggest that, for PEE patients, TPM should be the first choice of treatment followed by VPA-Na and CBZ. In developing countries, VPA-Mg should be the first choice. and PB is also good alternatives for PEE patients.