Tỉ lệ động kinh kháng trị và nguyên nhân trên bệnh nhân động kinh người lớn

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Tác giả: Văn Tuấn Lê, Hoàng Uyên Phương Nguyễn

Ngôn ngữ: Vie

Ký hiệu phân loại: 616.8 Diseases of nervous system and mental disorders

Thông tin xuất bản: Tạp chí Y học TP. Hồ Chí Minh 2021

Mô tả vật lý: 54-61

Bộ sưu tập: Metadata

ID: 409436

Thêm vào giỏ Liên kết toàn văn

Xác định tỉ lệ động kinh kháng trị, mô tả nguyên nhân và đặc điểm liên quan, đưa ra yếu tố nguy cơ kháng trị. Đối tượng - Phương pháp nghiên cứu: Đối tượng là các bệnh nhân động kinh 18 tuổi trở lên, theo dõi tại bệnh viện Nguyễn Tri Phương và bệnh viện Đại học y dược từ tháng 1/2020 đến tháng 5/2020, với phương pháp nghiên cứu cắt ngang mô tả. Bệnh nhân được thu thập thông tin theo bảng câu hỏi. Dựa trên tiêu chuẩn chẩn đoán kháng trị của Liên Hội Chống Động Kinh Quốc Tế 2010, chúng tôi tiến hành phân tích số liệu. Kết quả: Với 160 ca, tỉ lệ động kinh kháng trị là 20%. Nguyên nhân ưu thế trong nhóm này là xơ chai hải mã 37,5%, sau đó là đột quị và loạn sản vỏ não. 53,13% ca định khu thái dương, 78,13% ca phân loại căn nguyên cấu trúc. Yếu tố nguy cơ của kháng trị sau phân tích hồi qui đa biến là tần suất cơn co giật trước điều trị cao, định khu động kinh thùy thái dương, hoàn cảnh khởi phát cơn cả ngày và đêm, đáp ứng kém với thuốc chống động kinh đầu tiên. Kết luận: Với kết quả 5 ca động kinh có 1 ca kháng trị và các yếu tố nguy cơ sẽ giúp ích hơn cho các nhà lâm sàng nhận diện bệnh nhân động kinh kháng trị., Tóm tắt tiếng anh, Drug resistant epilepsy (DRE) is the severe problem for the neurologists. DRE lowers the quality of life, increases morbidity and mortality, despite that, there are few studies of DRE in Viet Nam. Objective: To determine the proportion of population of adult people with epilepsy (PWE), who suffer from DRE
to describe the etiologies and relevant characteristics and to estimate risk factors for DRE. Methods: All adult PWE from 18 years old who had attended at Nguyen Tri Phuong hospital and Ho Chi Minh city University of Medical Center from January, 2020 to May, 2020 were profiled for drug responses according to the definition for DRE as specified by the International League against Epilepsy (ILAE) 2010 consensus. This is a cross-sectional study. Data collected included demographics, characteristics of epilepsy, electroencephalogram, brain imaging findings and medication histories. Results: The prevalence rate of DRE in this study was 20% (n=160). The prominent causes of DRE are hippocampus sclerosis 37.5%, stroke and focal cortical dysplasia. 53.13% cases were classified as temporal epilepsy, and 78.13% cases had structural etiology. From multivariate analysis, high pretreatment seizure frequency, temporal epilepsy, both daytime and nighttime occurrence of seizures, poor outcome of first antiepileptic drug increased risk for DRE. Conclusion: The findings may aid clinician in recognizing and caring PWE, with careful considerations that at any given time, 1 in 5 PWE have DRE.

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