抗发作药物 ≤48小时预示着新发的更好的预后
Eric Ménétré1, Pia De Stefano1,2, Pierre Megevand1
1EEG & Epilepsy Unit, Department of Clinical Neurosciences, University Hospitals of Geneva, Geneva, Switzerland.
European journal of neurology
|October 27, 2023
概括
对新发性的即时抗发作药物 (ASM) 显著减少了的复发. 在第一次发作后48小时内开始ASM可以改善长期的结果和发作自由.
科学领域:
- 神经学 神经学
- 临床医学 临床医学
- 发病学 (Epileptology) 是一个专业的学科.
背景情况:
- 患有先前的新发性患者的复发率更高.
- 这凸显了抗发作药物 (ASM) 开始的关键时机.
- 建议在第一次发作后立即进行ASM,以改善患者的治疗结果.
研究的目的:
- 评估即时ASM与新发性患者结局之间的关联.
- 根据ASM治疗时间 (在48小时内或48小时后) 来比较发作复发率.
主要方法:
- 对1010名患者 (≥16岁) 进行的回顾性单中心研究,这些患者可能出现了第一次发作.
- 综合诊断工作包括EEG和神经成像.
- 5年的随访比较了48小时内接受治疗的患者和后来接受治疗的患者的发作复发率.
主要成果:
- 在487名NOE患者中,416人有治疗数据;80%在48小时内接受ASM.
- 与后期治疗相比 (56.6%;p<0.001) 立即ASM (≤48h) 的复发率显著降低 (32%).
- 在48小时内接受治疗的患者在5年内保持无的可能性显著增加 (p<0.001).
结论:
- 在48小时内立即进行ASM治疗与NOE患者在事件发生后5年内更好的预后有关.
- 这一回顾性分析表明,迅速启动治疗有好处.
- 需要进一步的前性研究来证实即时处理和ASM在NOE中的价值.
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