发作的复发与反应延迟有关,但与治疗后EEGEEG的传统属性无关
Emmi Deckard1, Rujuta Sathe1, David Tabibzadeh1
1Department of Pediatrics, Division of Neurology, University of California Los Angeles and UCLA Mattel Children's Hospital, California, Los Angeles, USA.
婴儿发作综合征 (IESS) 复发是常见的. 及时治疗是关键,因为更长的IESS持续时间在反应之前显著增加了复发风险. 对预测生物标志物的进一步研究是必要的.
科学领域:
- 儿科神经学 儿科神经学
- 发病学 (Epileptology) 是一个专业的学科.
- 临床神经科学 临床神经科学
背景情况:
- 婴儿发作综合征 (IESS) 的复发是初始治疗后经常出现的挑战.
- 之前对IESS复发风险因素的研究受限于样本规模较小和有关病因,治疗和EEG特征的不一致发现.
研究的目的:
- 在一个大型的,单中心的IESS队列中量化发作的复发风险.
- 为了确定与IESS复发相关的特定临床和EEG因素.
主要方法:
- 对一大批被诊断患有IESS的儿童进行了回顾性分析.
- 关于治疗,反应,复发,病因和EEG特征的数据从电子病历中提取出来.
- 使用Cox比例危险回归分析了没有复发的存活率.
主要成果:
- 在599名患有IESS的儿童中,197人对初级治疗 (荷尔蒙疗法/维加巴特林) 有反应.
- 回答者中有21% (41/197) 在12个月内复发.
- 在获得反应 (>3个月) 之前,IESS的持续时间较长是复发时间较短的显著预测因素 (HR=3.11,p=0.001).
结论:
- 在初始治疗反应之前,IESS的长时间持续是复发的主要临床预测因素.
- 迅速有效的初始治疗对于减轻IESS复发风险至关重要.
- 对生物标志物和向疗法的进一步研究是有必要的,以防止IESS复发.
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