Publication: Politerapi kullanan epilepsi hastalarının monoterapi kullanan Hastalardan farklılıkları
Abstract
Amaç: Bu çalışmanın amacı politerapi altındaki (birden fazla antiepileptik kullanan) epilepsi hastalarının demografik, klinik, nörolojik muayene ve görüntüleme sonuçlarının incelenerek politerapi ihtiyacına eşlik eden faktörlerin belirlenmesidir. Hastalar ve Yöntem: Marmara Üniversite Hastanesi Epilepsi polikliniğinde takipli 785 epileptik hastanın dosyası retrospektif olarak taranıp, hazırlanan formlar doldurulmuştur. Hastalar monoterapi ya da politerapi kullanmalarına göre gruplanmıştır. İki grup demografik veriler, klinik özellikler, nörolojik muayene ve görüntüleme sonuçları açısından Student-t ve ki-kare testleri ile karşılaştırılmıştır. Bulgular: Politerapi kullanan hasta grubunda öyküde kraniyotomi, intrakraniyal tümör, basit parsiyel nöbet ve konvülsif status epileptikus, nörolojik muayenede patolojik bulgu görülmesi, EEG, kranial görüntüleme (MR/BT) ve SPECTde patoloji saptanması monoterapi kullanan hasta grubundan daha yüksek bulunmuştur. Sonuç: Politerapi epilepsi tedavisinde önemli bir basamaktır. Ancak ilaç-ilaç etkileşimi olasılığı ve artan ilaç yan etkileri nedeniyle ilk seçenek olarak kabul edilmemektedir. Politerapi kullanacak hastaların monoterapi ile nöbetleri kontrol altına alınabilen hastalardan farklılıkların belirlenmesi, politerapi ihtiyacının tedavinin öncesinde tahmin edilmesi açısından faydalı olacaktır. (Marmara Üniversitesi Tıp Fakültesi Dergisi 2012;25:123-7)
Objective: This study aimed to evaluate demographical variables, clinical features, neurological examination and cranial imaging results which cause or determine the necessity for politherapy treatment in epilepsy patients. Patients and Methods: The patient files of 785 epileptic patients were followed by Marmara University Epilepsy Outpatient Clinic were scanned retrospectively and a questionnaire was filled in for each file. Patients were grouped as monotherapy or politherapy, considering the number of antiepileptics they used. The demographical variables, clinical features, neurological examination and imaging results of the two groups were compared. The results were analyzed by Student's-t test and chi-square tests. Results: A history of craniotomy and intracranial tumors is more frequent in politherapy patients. Also, simple partial seizure, convulsive status epilepticus, pathological neurological examination findings, abnormal EEG, cranial imaging (MRI/CT) and SPECT results were found to be higher in politherapy patients. Conclusion: Politherapy is an important step in epilepsy treatment. However, because of drug-drug interactions and drug side effects it is not the first choice. Determining the differences between patients who use politherapy and monotherapy will help recognizing the clinical data which may lead to politherapy need. (Marmara Medical Journal 2012;25:123-7)
Objective: This study aimed to evaluate demographical variables, clinical features, neurological examination and cranial imaging results which cause or determine the necessity for politherapy treatment in epilepsy patients. Patients and Methods: The patient files of 785 epileptic patients were followed by Marmara University Epilepsy Outpatient Clinic were scanned retrospectively and a questionnaire was filled in for each file. Patients were grouped as monotherapy or politherapy, considering the number of antiepileptics they used. The demographical variables, clinical features, neurological examination and imaging results of the two groups were compared. The results were analyzed by Student's-t test and chi-square tests. Results: A history of craniotomy and intracranial tumors is more frequent in politherapy patients. Also, simple partial seizure, convulsive status epilepticus, pathological neurological examination findings, abnormal EEG, cranial imaging (MRI/CT) and SPECT results were found to be higher in politherapy patients. Conclusion: Politherapy is an important step in epilepsy treatment. However, because of drug-drug interactions and drug side effects it is not the first choice. Determining the differences between patients who use politherapy and monotherapy will help recognizing the clinical data which may lead to politherapy need. (Marmara Medical Journal 2012;25:123-7)