Objective To provide the reference for clinical prognosis evaluations and therapeutic sched-ule by observing the long-term outcome of outpatients with epilepsy experiencing initial monotherapy failure.Methods Thousands of patients with epilepsy were registered in the epilepsy outpatient department of Renmin Hospital of Wuhan University from March 2008 to June 2021.We reviewed and collected the detailed data of the patients who experienced failure of the first single drug treatment,adhered to the standardized anti-epilep-tic therapy as prescribed by the doctor and clinical follow-up regularly(≥5 years).The modernstatistical methods were used to analyse the above data.Results A total of 104 cases were collected,including 63 males and 41 females.The average age of patients was 20.14 years old.The average course of epilepsy disease was 10.33 years.All of them were followed up to the 6th year,but some were gradually lost since the 7th year.The proportion of annual epileptic seizure were 95(91.3％),76(73.1％),64(61.5％),49(47.1％),51(49％),and 57(54.8％)from the first year to the sixth year,respectively.During the six years,there were 3 cases(2.9％)with no epileptic seizure,32 cases(30.8％)with epileptic seizure every year and 69 cases(66.3％)with recurrence after two to five years of no epileptic seizure.At the 6th year,the end point of the study,the recurrence situation of patients who had no epileptic seizure for two to five years were 2/16(12.5％),13/23(56.5％),3/11(27.3％)and 1/4(25％).The data of patients in the seizure group and the non-seizure group at the 6th year were analyzed.It was found that craniocerebral disease or trauma and head MRI/CT abnormalities were more common in the seizure group(P＜0.05).Conclusion The seizure was rela-tively hard to control in patients with a long history of epilepsy for about 10 years,craniocerebral disease or trauma,abnormal head MRI/CT images,and the failure of the first standardized antiepileptic monotherapy which may be high risk factors for refractory epilepsy.The highest recurrence rate was seen in patients who had no epileptic seizure continuously for 3 years.It was recommended that such patients should delay the time of reducing drug dose and types and stopping medication,and surgical treatment of epilepsy could be preferred if appropriate.
关键词
初次单药失败/长期结局/难治性癫痫/复发/癫痫手术
Key words
The failure of single drug for the first time/Long term Outcome/Refractory/epilepsy Relapse/Epilepsy surgery
维普
万方数据