Özlem UZUNKAYA ETHEMOĞLU, Mehtap KOCATÜRK, KADRİ BURAK ETHEMOĞLU

Harran Tıp Fakültesi Epilepsi Polikliniğinde Takipli Semptomatik Epilepsi Hastalarının Demografik, Klinik Bulguları ve Prognozu

Amaç: Harran Üniversitesi Tıp Fakültesi Epilepsi Polikliniği’inden takipli semptomatik epilepsili hasta grubunun demografik ve klinik özellikleri incelendi ve epilepsi polikliniğinde düzenli takibin prognoz üzerindeki etkinliği araştırıldı. Gereç ve Yöntem: Harran Üniversitesi Tıp Fakültesi Epilepsi Polikliniğinde Eylül 2015– Haziran 2016 tarihleri arasında takip edilen 210 hasta retrospektif olarak değerlendirildi ve öyküsünde semptomatik epilepsi düşünülen ve beraberinde beyin görüntülemesinde nöbet geçirme riskini artıran yapısal lezyonu olan 44 hasta çalışmaya alındı. Bulgular: Hastaların 5’i (%11.4) kortikal gelişimsel malformasyon, 3‘ü (%6.8) nörokütanöz sendrom, 5’i (11.4) tümör, 10’u (%22.7) kafa travması, 10’u (%22.7) perinatal hasar, 8’i (%18.2) ensefalomalazi, 2’si (%4.5) ensefalit sekeli, 1’i (%2.3) mesial temporal skleroz hastası idi. Epilepsi polikliniğimize başvurduğunda 10 hastanın nöbetleri kontrol altındaydı. Nöbetleri kontrol altında olmayan 34 (%81.8) hastanın tedavisinde değişiklik yapıldı. Bunların 21’i (%47.7) sadece ilaç doz artışı, 7’si (%15.9) hem yeni ilaç eklenmesi hem de mevcut antiepileptik doz artışı, 6‘sı (%13,6) sadece yeni ilaç eklenmesi şeklindeydi. Takiplerinde 12 hastada nöbet kontrolü, 12 hastada nöbet sıklığında %50’den fazla azalma, 7 hastada %50’den az azalma gözlendi. Bir hastada ise değişiklik olmadı. Onbeş (%34.1) hasta dirençli epilepsi olarak değerlendirildi. Sonuç: Tedaviye dirençli epilepsisi olan semptomatik epilepsi hastalarında epilepsi polikliniğinden düzenli takibin ve ilaç tedavisinin düzenlenmesinin nöbet kontrolü üzerine olumlu etkileri vardır.

Demografic, Clinical Findings and Prognosis of Patients with Symptomatic Epilepsy Followed Up at The Epilepsy Clinic of Harran University Faculty of Medicine

Objective: The demographic and clinical characteristics of the symptomatic epilepsy patients followed up at the epilepsy clinic of Harran University Faculty of Medicine were investigated and the efficacy of prospective follow-up on epilepsy polyclinic was evaluated. Material and Method: 210 of patients treated at the epilepsy outpatient clinic between September 2015- June 2016 were evaluated retrospectively and 44 patients with suspected symptomatic epilepsy and a structural lesion that increased the risk of seizure on brain imaging were included in the study. Results: Five patients (11.4%) had cortical developmental malformation , 3 (6.8%) neurocutaneous syndrome, 5 (11.4) tumor, 10 (22.7%) head trauma, 10 (22.7%) perinatal injury, 8 (18.2%) encephalomalacia, 2 (4.5%) encephalitis sequelae and 1 (2.3%) patient with mesial temporal sclerosis. The seizures of 10 patients were under control when they applied to our epilepsy outpatient clinic. The treatment of 34 (81.8%) patients whose seizures were not under control was changed. 21 of them (47.7%) had only drug dose increase, 7 (15.9%) both new drug addition and current antiepileptic dose increase, and 6 (13.6%) only new drug addition. 12 (28.9%) patients had seizure control. 12 (26.7%) patients had more than 50% reduction in seizure frequency and 7 (17.8%) patients had less than 50% reduction. Seizures of 1 (2.2%) patient did not change. 15 (34.1%) patients were evaluated as drug resistant epilepsy. Conclusion: Regular follow-up from epilepsy polyclinic and the regulation of drug treatment have positive effects on seizure control in symptomatic epilepsy patients with treatment-resistant epilepsy

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