Issues in Diagnosis, Treatment and Management of Epileptic Children in Enshi (A Retrospective Study of 225 Cases)

YANG Qian; WANG Fang

doi:10.3969/j.issn.1002-3429.2015.04.11

Abstract：Objective To discuss diagnosis, treatment and management of epileptic children in Enshi in order to im-prove the levels of diagnosis and treatment. Methods A Retrospective analysis of diagnosis and treatment, classifications and prognosis were made on 225 cases of epileptic children in the department of pediatrics of our hospital during January and De-cember 2011. Results 142 cases (63. 1%) were diagnosed as epilepsy in other hospitals and only 5 cases (3. 5%) were classified as epilepsy syndrome;46 cases (32. 4%) were misdiagnosed, among which, 22 epileptic children were misdiag-nosed with other diseases, while 24 non-epileptic cases were misdiagnosed as epilepsy. The initial treatment of 116 cases (81. 7%) was not standard, among which, 92 cases took two kinds of antiepileptic drugs (including 84 cases from rural are-as) , while 24 cases failed to have sufficient dosages. ①201 cases were diagnosed as epilepsy in our hospital, only 21 cases (10. 4%) could not be classified as epilepsy syndrome and other 180 cases were classified according to the diagnostic criteria of 2010 International League Against Epilepsy (ILAE). 22 cases (10. 9%) were not given any treatment of antiepileptic drugs. 135 cases (67. 2%) took monotherapy and two kinds of antiepileptic drugs were used to treat 33 cases (16. 4%), while 11 cases (5. 5%) were treated with three kinds of antiepileptic drugs. The 1-year follow-up rate was 79. 6%. 112 cases (55. 7%) cut back on dosages or stopped taking drugs without authorization within one year, including 44. 3% cases from ru-ral areas. After treatment of antiepileptic drugs, 121 cases (60. 2%) was totally controlled, and 59 cases (29. 4%) were ef-fectively controlled, while 21 cases (10. 4%) were invalid. ②24 cases were diagnosis as non-epileptic diseases in our hospi-tal. 10 cerebral palsy symptoms improved and the other 14 cases were totally cured. Conclusion For diagnosis of epileptic children, first, we must determine the type of epilepsy. Drugs must be chosen with definite therapeutic effect and better com-pliance according to the principle of standardization and individuation. Strengthened follow-up and management of epileptic children in rural areas during intensive treatment should be conducive in improving the cure rate of the disease.