Kliniczne i przyczynowe formy epilepsji u dzieci według międzynarodowej klasyfikacji ILAE z 2017 roku
Clınıcal and aetıologıcal spectrum of chıldhood epılepsy accordıng to the ILAE 2017 classıfıcatıon
W skrócie
Badanie analizowało 622 dzieci z epilepsją w dużym szpitalu specjalistycznym, clasificując je według nowych międzynarodowych standardów. Najczęściej występowała epilepsja uogólniona (65%), a przyczynę choroby znaleziono u 37% pacjentów - najczęściej były to zmianami strukturalne mózgu, rzadziej przyczyny genetyczne lub zakażenia. U 15% dzieci choroba okazała się oporna na leczenie, wymagając stosowania trzech lub więcej leków, a u wielu pacjentów przyczyna epilepsji pozostała nieznana pomimo badań specjalistycznych.
Oryginalny abstract (angielski)
OBJECTIVE: This study aimed to describe the clinical features, etiological distribution, comorbidities, and treatment patterns of childhood epilepsy using the International League Against Epilepsy 2017 classification in a real world tertiary care setting. METHODS: We retrospectively reviewed 622 children with epilepsy followed at a tertiary referral centre. Patients were classified according to age at diagnosis and evaluated in terms of epilepsy and seizure types, etiological, neurological findings, electroencephalography and neuroimaging results, comorbidities and antiseizure medication use. RESULTS: Generalized epilepsy was the most common epilepsy type, accounting for 65.4% of cases. An underlying etiological was identified in 37.5% of patients, with structural causes being the most frequent, followed by genetic, metabolic, infectious, and immune-mediated causes. The proportion of unknown etiological was highest among patients diagnosed after 10 years of age. Early-onset epilepsy was more often associated with structural and genetic causes, neurodevelopmental impairment, and abnormal neuroimaging findings. Drug resistance, defined as treatment with three or more antiseizure medications, was observed in 15.0% of patients. CONCLUSIONS: Application of the ILAE 2017 classification in this large pediatric cohort revealed important age-related differences in etiological, comorbidities, and treatment response. Despite tertiary-level follow-up, a substantial proportion of children remained without an identified cause, highlighting the need for improved access to advanced diagnostic investigations, particularly genetic testing.