The Related Factors Of Seizure And Remission Of Newly Diagnosed Childrenwith Epilepsy After Antiepileptic Drug Treatment

ObjectiveProspectively analysis the newly diagnosed epilepsy drug treatment for children after the attack, clearly influence the onset or uncontrolled factors, forecast for newly diagnosed epileptic children to alleviate the risk factors and provide a reference and judge information for epilepsy treatment effect and prognosis. MethodsChildren who vistied Zhengzhou University People’s Hospital pediatric neurology specialist outpatient clinics and wards from January 2013 to December 2013 were collected, according to the 2010 ILAE epilepsy on the classification newly diagnosed children with epilepsy and according to the ILAE treatment guidelines to give a reasonable therapy of antiepileptic drugs(AEDs). Regularly following-up observation for 2 years.Basic data:(1) General information: name, sex, date of birth, weight, name and address, parents, name and education background;(2) Seizure features: date and age for the first seizure, seizures type, incentive, day or night when seizure, duration, there is or no loss of consciousness,according symptoms, after the onset of seizures, status epilepticus,frequency of seizure before taking AEDs;(3)The related history: family history, birth history, disease history, pregnancy, history of febrile seizures, and there are no complications;(4) Auxiliary examination: EEG examination including conventional and 24 hours video EEG, head CT or MRI;(5) Medications : onset time for medication, antiepileptic drug types, starting dose and concentration.Follow-up: Newly diagnosed children with epilepsy visited outpatient first month after treatment January and then every 3 months and described in detail whether seizure, and the cause, number, frequency, form, duration during the follow-up period. Every candidate need take 24 hours of video EEG after 1 years of drug treatment. ResultsA total of 115 children with newly diagnosed epilepsy were recruited, taking antiepileptic drugs after third months, 6 months, 12 months and 24 months, the seizure rate were 34.78%, 45.22%, 53.04%, 60.90%. Within 1 year after drug trearment, the seizure rate accounted for 87.09% of the total rate during the follow-up period. At the end of follow-up,74 children with epilepsy reached remission,the proportion was 64.35%.The Cox regression model analysis for seizure with newly diagnosed children with epilepsy during follow-up period showed that :more than 5 seizures before drug treatment(HR=0.478,95%CI 0.344-1.061,P=0.047), abnormal EEG both before(HR=2.41,95%CI 1.189 ~ 4.852,P=0.015) and 1 year after(HR=0.45,95%CI 0.266~0.776,P=0.04) drug treatment. Number of seizures before drug treatment(HR=1.432,95%CI 0.912-1.793,P=0.045) and abnormal EEG after 1 year drug treatment(HR=0.986,95%CI 0.873-2.142,P=0.023) and seizures undering treatment(HR=2.19,95%CI 1.174-4.081,P=0.012) were major risk factors for remission. Conclusion 1. Seizure after drug treatment with newly diagnosed children with epilepsy mostly occurred in first year after the treatment. 2. Children with more than 5 seizures before drug treatment,or abnormal EEG before drug treatment, as well as abnormal EEG after 1 year drug treatment tend to experience the seizure after drug treatment. 3. Number of seizures before drug treatment and abnormal EEG after 1 year drug treatment and seizure seizures undering treatment were significant risk factors for newly diagnosed children with epilepsy achieving remission.