Effects of etiology and preoperative course of disease on the efficacy of drug-resistant epilepsy in children

doi:10.3969/j.issn.1004-583X.2025.06.008

Abstract

Abstract:

Objective To analyze the influence of etiology and preoperative course of disease on the curative effect of children with drug-resistant epilepsy (DRE) in a single center. Methods A retrospective analysis was conducted on 48 pediatric patients with DRE admitted to Xiamen Humanity Hospital Affiliated to Fujian Medical University between January 1, 2021, and December 31, 2022. Clinical data of the patients were collected and they were followed up to analyze the relationship between different etiologies, preoperative disease duration, and treatment outcomes. Additionally, the evaluation of postoperative efficacy was explored. Results There was no significant difference in the efficacy between subgroups of genetic etiology and structural etiology (OR=4.754, 95%CI=0.980-23.074, P=0.053). Logistic regression analysis showed that OR>1, suggesting that genetic causes may increase the risk of poor efficacy compared with structural causes. For every one-year increase in the course of disease before surgery, the treatment effect was significantly improved (P<0.05). Conclusion Genetic causes are associated with an increased risk of poor prognosis of DRE compared to structural causes. For children with non-early-onset epilepsy and lighter seizure burden, a longer preoperative course indicates a better surgical effect.

Key words: drug resistant epilepsy, pathogenesis, course, treatment outcome

CLC Number:

R742.1

Lin Bincheng, Lin Gangxi. Effects of etiology and preoperative course of disease on the efficacy of drug-resistant epilepsy in children[J]. Clinical Focus, 2025, 40(6): 527-531.

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URL: http://www.lchc.cn/EN/10.3969/j.issn.1004-583X.2025.06.008

http://www.lchc.cn/EN/Y2025/V40/I6/527

Figures/Tables 5

References 26

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疗效分类	定义
良好	50%≤发作频率减少<75%
	发作频率减少≥75%
	无发作
较差	发作频率减少<50%
	发作加重(发作频率增加≥25%)

疗效分类	定义
良好	50%≤发作频率减少<75%
	发作频率减少≥75%
	无发作
较差	发作频率减少<50%
	发作加重(发作频率增加≥25%)

临床资料	例数[(%)]
年龄
起病年龄
新生儿期	2(4.2)
婴儿期	38(79.2)
儿童期	8(16.6)
手术年龄
未手术	11(22.9)
婴儿期	10(20.8)
儿童期	27(56.3)
性别
男	27(56.2)
女	21(43.8)
癫痫综合征	11(22.9)
婴儿癫痫性痉挛综合征	8(16.6)
伦诺克斯-加斯托综合征	3(6.3)
病因
结构性	28(58.3)
皮质发育畸形	22(45.8)
获得性脑损伤	6(12.5)
遗传性	15(31.3)
病因不明	5(10.4)
发育情况
发育迟缓/智力障碍	46(95.8)
发育正常	2(4.2)
疗效
疗效良好	25(52.1)
疗效较差	23(47.9)
手术治疗	37(77.1)
单一手术方式	13(27.1)
两种及以上手术方式	24(50.0)

临床资料	例数[(%)]
年龄
起病年龄
新生儿期	2(4.2)
婴儿期	38(79.2)
儿童期	8(16.6)
手术年龄
未手术	11(22.9)
婴儿期	10(20.8)
儿童期	27(56.3)
性别
男	27(56.2)
女	21(43.8)
癫痫综合征	11(22.9)
婴儿癫痫性痉挛综合征	8(16.6)
伦诺克斯-加斯托综合征	3(6.3)
病因
结构性	28(58.3)
皮质发育畸形	22(45.8)
获得性脑损伤	6(12.5)
遗传性	15(31.3)
病因不明	5(10.4)
发育情况
发育迟缓/智力障碍	46(95.8)
发育正常	2(4.2)
疗效
疗效良好	25(52.1)
疗效较差	23(47.9)
手术治疗	37(77.1)
单一手术方式	13(27.1)
两种及以上手术方式	24(50.0)

病因	模型1		模型2
病因	OR值(95%CI)	P值	OR值(95%CI)	P值
结构性	1		1
遗传性	2.318(0.644~8.350)	0.198	4.754(0.980~23.074)	0.053
不明原因	2.318(0.332~16.185)	0.396	2.749(0.280~26.996)	0.386