Hyun-Jin Kim, Min-Jee Kim, Eon Ah Kim, Ohcheol Kwon, Yun Sung Nam, Mi-Sun Yum , Tae-Sung Ko
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引用次数: 0
Abstract
Objectives
Epilepsy is the most common serious neurological disorder in children; however, previous long-term studies are often limited by small sample sizes or methodological variability. This study aimed to assess the epidemiology, seizure outcomes, and prognostic factors of childhood-onset epilepsy over > 10 years of follow-up at a single tertiary center.
Methods
We retrospectively analyzed the medical records of 4248 patients diagnosed with epilepsy before age 19 between 1995 and 2017 at Asan Medical Center Children’s Hospital. All patients underwent at least one electroencephalogram (EEG) and received anti-seizure medications (ASMs) for > 2 years.
Results
During a mean follow-up of 11.0 years, 43 patients (1.0 %) died. The median age at seizure onset was 7.2 years. Etiologies included unknown (52.5 %), structural (29.3 %), genetic/metabolic (23.4 %), and infectious/autoimmune (4.5 %). Focal epilepsy was the most common (63.4 %). Neurocognitive and psychological comorbidities were observed in 32.7 % and 20.6 % of patients, respectively. Seizure freedom for ≥ 2 years was achieved in 81.2 %, and terminal remission in 63.1 %. However, relapse occurred in 38.0 %, and 28.6 % developed intractable epilepsy. Prognostic factors included status epilepticus, intellectual disability, pretreatment seizure frequency, etiology, epilepsy syndromes, and EEG abnormalities.
Conclusions
This study reaffirms known risk factors while providing comprehensive insights into seizure trajectories, relapse patterns, and treatment responses in a large cohort. It highlights the clinical relevance of the 2-year seizure-free definition and underscores the need for early interventions in high-risk subgroups. Despite diagnostic advances, several cases remain etiologically unresolved, reinforcing the importance of expanding access to molecular and imaging tools in pediatric epilepsy care.
期刊介绍:
Epilepsy Research provides for publication of high quality articles in both basic and clinical epilepsy research, with a special emphasis on translational research that ultimately relates to epilepsy as a human condition. The journal is intended to provide a forum for reporting the best and most rigorous epilepsy research from all disciplines ranging from biophysics and molecular biology to epidemiological and psychosocial research. As such the journal will publish original papers relevant to epilepsy from any scientific discipline and also studies of a multidisciplinary nature. Clinical and experimental research papers adopting fresh conceptual approaches to the study of epilepsy and its treatment are encouraged. The overriding criteria for publication are novelty, significant clinical or experimental relevance, and interest to a multidisciplinary audience in the broad arena of epilepsy. Review articles focused on any topic of epilepsy research will also be considered, but only if they present an exceptionally clear synthesis of current knowledge and future directions of a research area, based on a critical assessment of the available data or on hypotheses that are likely to stimulate more critical thinking and further advances in an area of epilepsy research.