无综合征诊断的全身强直阵挛发作 (GTCS) 患者
总体而言，所有 GTCS 患者对治疗的反应良好。当作出准确的癫痫综合征诊断并选择合适的治疗药物时，大多数患者反应良好，约 60% 的患者实现无发作。[50]Kwan P, Brodie MJ. Early identification of refractory epilepsy. N Engl J Med. 2000 Feb 3;342(5):314-9.http://www.nejm.org/doi/full/10.1056/NEJM200002033420503#t=articlehttp://www.ncbi.nlm.nih.gov/pubmed/10660394?tool=bestpractice.com[51]Kwan P, Brodie MJ. Effectiveness of first antiepileptic drug. Epilepsia. 2001 Oct;42(10):1255-60.http://www.ncbi.nlm.nih.gov/pubmed/11737159?tool=bestpractice.com[52]Mohanraj R, Brodie MJ. Pharmacological outcomes in newly diagnosed epilepsy. Epilepsy Behav. 2005 May;6(3):382-7.http://www.ncbi.nlm.nih.gov/pubmed/15820347?tool=bestpractice.com[53]Mohanraj R, Brodie MJ. Outcomes of newly diagnosed idiopathic generalized epilepsy syndromes in a non-pediatric setting. Acta Neurol Scand. 2007 Mar;115(3):204-8.http://www.ncbi.nlm.nih.gov/pubmed/17295717?tool=bestpractice.com[138]Brodie MJ, Kwan P. Staged approach to epilepsy management. Neurology. 2002 Apr 23;58(8 Suppl 5):S2-8.http://www.ncbi.nlm.nih.gov/pubmed/11971127?tool=bestpractice.com
存在局灶发作型癫痫的 GTCS 患者
总体而言，约 50% 局灶性起源癫痫症患者将对其首次药物治疗有疗效，并实现了癫痫无发作状态。[50]Kwan P, Brodie MJ. Early identification of refractory epilepsy. N Engl J Med. 2000 Feb 3;342(5):314-9.http://www.nejm.org/doi/full/10.1056/NEJM200002033420503#t=articlehttp://www.ncbi.nlm.nih.gov/pubmed/10660394?tool=bestpractice.com[51]Kwan P, Brodie MJ. Effectiveness of first antiepileptic drug. Epilepsia. 2001 Oct;42(10):1255-60.http://www.ncbi.nlm.nih.gov/pubmed/11737159?tool=bestpractice.com[52]Mohanraj R, Brodie MJ. Pharmacological outcomes in newly diagnosed epilepsy. Epilepsy Behav. 2005 May;6(3):382-7.http://www.ncbi.nlm.nih.gov/pubmed/15820347?tool=bestpractice.com 首次药物治疗失败的患者需接受第二种药物，进行单药疗法或双重疗法；这些患者中约 10% 的患者会在第二次药物治疗后实现无发作。[138]Brodie MJ, Kwan P. Staged approach to epilepsy management. Neurology. 2002 Apr 23;58(8 Suppl 5):S2-8.http://www.ncbi.nlm.nih.gov/pubmed/11971127?tool=bestpractice.com 其余的 30%-40% 的患者将对治疗产生抵抗性，而一小部分有治疗成功的机会。[50]Kwan P, Brodie MJ. Early identification of refractory epilepsy. N Engl J Med. 2000 Feb 3;342(5):314-9.http://www.nejm.org/doi/full/10.1056/NEJM200002033420503#t=articlehttp://www.ncbi.nlm.nih.gov/pubmed/10660394?tool=bestpractice.com[138]Brodie MJ, Kwan P. Staged approach to epilepsy management. Neurology. 2002 Apr 23;58(8 Suppl 5):S2-8.http://www.ncbi.nlm.nih.gov/pubmed/11971127?tool=bestpractice.com
存在 GTCS 的全面性癫痫发作综合征患者
如果选择了合适的治疗药物，60%-70% 的全面性起源的癫痫患者将无癫痫发作。[51]Kwan P, Brodie MJ. Effectiveness of first antiepileptic drug. Epilepsia. 2001 Oct;42(10):1255-60.http://www.ncbi.nlm.nih.gov/pubmed/11737159?tool=bestpractice.com[52]Mohanraj R, Brodie MJ. Pharmacological outcomes in newly diagnosed epilepsy. Epilepsy Behav. 2005 May;6(3):382-7.http://www.ncbi.nlm.nih.gov/pubmed/15820347?tool=bestpractice.com[53]Mohanraj R, Brodie MJ. Outcomes of newly diagnosed idiopathic generalized epilepsy syndromes in a non-pediatric setting. Acta Neurol Scand. 2007 Mar;115(3):204-8.http://www.ncbi.nlm.nih.gov/pubmed/17295717?tool=bestpractice.com 全面性起源癫痫患者的无发作率高于有症状或隐源性局灶性起源的癫痫患者。
