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目的 探讨全面强直 阵挛性发作 (GTCS)癫疒间 患者的预后。方法 对 16 8例GTCS患者进行11～ 2 2年的临床随访 ,观察抗癫疒间 药物疗效及治疗后的智能和生活质量。结果 随访结束时 ,停药 2 1例(12 5 % ) ,仍服药者 14 7例 (87 5 % ) ;16 5例 (98 2 % )正规抗癫疒间 治疗能有效控制癫疒间 发作 ,117例 (84 8% )停药 1 33年后复发 ,继续服药仍能控制 ,无 1例发生癫疒间 持续状态。 2 8例 (16 6 7% )患者出现精神症状 ,以情感障碍较突出。癫疒间 组总智商与正常对照组比较无差异 ,发作控制组与未控制组比较无差异 (均P >0 0 5 ) ,但生活质量癫疒间组明显低于正常对照组 (P <0 0 1)。结论 GTCS患者须长期服药治疗 ,智力不受影响 ,但生活质量低于正常人。服药治疗的同时配合心理治疗 ,可提高其生活质量
Objective To investigate the prognosis of patients with total tonic-clonic seizure (GTCS) epilepsy. Methods A total of 16 8 GTCS patients were followed up for 11 to 22 years to observe the efficacy of anti-epileptic drugs and the post-treatment intelligence and quality of life. Results At the end of follow-up, 21 (12.5%) discontinued and 14 (87.5%) still taking the medication, and 16.5 (98.2%) formal antiepileptic treatments were effective in controlling epileptic seizures, One hundred and seventy-seven patients (84.8%) discontinued and relapsed after 33 years. The medication was still controlled and none of them sustained status epilepticus. Twenty-eight patients (16.7%) developed psychiatric symptoms, with prominent affective disorders. There was no difference in total IQ between epilepsy group and normal control group, but there was no difference between seizure control group and uncontrolled group (P> 0.05), but the quality of life in epilepsy group was significantly lower than that in normal control group (P <0 0 1). Conclusion GTCS patients need long-term medication, intelligence is not affected, but the quality of life is lower than normal. Medication treatment at the same time with psychotherapy, can improve their quality of life