Diagnosis And Treatment Research Of Childhood Epilepsy

BackgroundEpilepsy is one of the most common pediatric diseases of the nervous system, causing great harm to children’s physical and mental health, and a heavy ideological and economic burden to family and society. At present, the main measures of treating epilepsy is to use antiepileptic drugs in a long periodic, standardized way. However, due to various factors,many patients can not get timely, regular and effective treatment.Then,the disease continues, which seriously affects the quality of life of the patients. Therefore, the comprehensive prevention and treatment of epilepsy needs to be further strengthened.In recent years, with the rapid development of basic research and diagnosis technology, more and more clinical research provides scientific basis for the prevention and treatment of epilepsy, thereby reducing the incidence, raise the cure rate. But the researches on etiology, seizure and epilepsy syndrome types, clinical diagnosis and treatment, and prognosis of children with epilepsy on large sample is still lack in the domestic.ObjectiveTo research diagnosis and treatment of childhood epilepsy in the recent7years of our hospital, analyse the characteristics of epilepsy in children, features of etiology, seizure and epilepsy syndrome types and prognosis, and examine the standard of diagnosis and treatment,then to guide the clinical work.MethodsChildren with epilepsy who were recorded in outpatient department of pediatrics and hospitalized patients in Henan Province People’s Hospital from October12005to September12012were included. The treating information of patients was got by filling in the questionnaire in patients with epilepsy through the method of out-patient registration or in-patient telephone follow-up. Seizure types and epilepsy syndromes were classified according to the guidelines(2011) of the International League Against Epilepsy.The etiology,anti-epileptic-drugs effect and prognosis of patients were studied. All statistical analyses were performed by SPSS17.0software. The statistic significance was defined as P<0.05.Results1. Characteristics of epilepsy In all patients, of which66.4%were male,33.6%were female,male/female rate was1.98:1. The average start-age was4.33±3.58years(3days-18years).43.5%started seizures less than3years old,less than1year old was the peak of start-age(22.8%). With the age growing,ratio showed a trend of decreasing. Ave-rage of age was (6.14±3.87)years(1month to18years),1245patients(48.1%) were less than6years old.2. Etiolog In all patients, of which16.8%were idiopathic etiology,46.3%were symptomatic etiology,36.9%were cryptogenic etiology.Perinatal factors were the most frequently found cause of epilepsy(44.0%) in symptomatic etiology, followed by the brain structural abnormalities(24.1%);in the postpartum anomaly, central nervous system infections accounted for the highest proportion (67.5%).3. Seizure types analysis This study showed that focal seizures were more than generalized seizures. In total,generalized seizures accounted for44.9%,focal seizures accounted for47.0%, undetermined epilepsy accounted for8.1%. Generalized seizures were more than focal seizures in children less than5years old.886patients(33.9%) were diagnosed as epilepsy syndrome.4. Treatment outcomes and follow-up Average follow-up time was (29.64±0.96) monthes (3-85monthes). At the end of the follow-up,1325patients (50.8%) were controlled,342patients (13.1%) were obvious effect,224patients (8.6%) had effect, the total effective rate was72.5%.716patients (27.5%) had no effect, in which389patients (14.9%) were referred to refractory epilepsy, relapse occurred in32patients. Idiopathic epilepsy and good coherent probably indicted a good effect.Side effect rate was10.9%.Conclusion1. Most childhood epilepsy began less than5years old,less than1year old accounted for about one quarter,with the age growing,ratio showed a trend of decreasing.2. Perinatal hypoxia/asphyxia and brain structural abnormalities may be the role risk factors of epilepsy in children. Central nervous system infections are the most important factors in the postpartum anomaly.3. Focal seizures were more than generalized seizures of childhood epilepsy. Generalized seizures were more than focal seizures in children less than5years old.4. West syndrome,Dravet syndrome,benign childhood epilepsy with centro-temporal spikes and Febrile Seizures plus are the most commen in the epilepsy syndrome.5. The prognosis was good among children with epilepsy.Etiology, seizure type, epilepsy syndrome and coherence of anti-epileptic drugs may be the main factors to prognosis.