幼年发病的癫痫患者获得驾照与癫痫复发关系的研究

作     者：SillanpM. Shinnar S. 邓剑平 

作者机构：Department of Public Health Turku University 20014 Turku Finland Dr. 

出 版 物：《世界核心医学期刊文摘（神经病学分册）》 (Digest of the World Core Medical Journals:Clinical Neurology)

年 卷 期：2005年第1卷第7期

页      面：49-49页

学科分类：1002[医学-临床医学] 100204[医学-神经病学] 10[医学] 

主　　题：epilepsy seizure license childhood 学习障碍 persist 复发率 likely relapse actually 

摘      要：Objective: To examine factors influencing obtaining a driver’s license and su bsequent prognosis among people with epilepsy vs control subjects. Methods: Eigh ty-one patients from a population-based cohort with childhood-onset epilepsy, followed prospectively for 45 years, and 96 general population control subjects were compared with regard to driving licensing, seizure relapses, and accidents . Results: By the end of the follow-up period, all 81 subjects had achieved at least one 2-year seizurefree interval in adulthood and were eligible for a driv er’s *** these, 64 vs 90%of control subjects had obtained a license (p 0.0001). On multivariable analysis, factors associated with not obtaining a dri ver’s license among subjects were female gender (relative risk [RR] 2.4, 95%CI 1.0 to 5.5, p = 0.02),nonidiopathic etiology (RR 2.0, 95%CI 1.1 to 3.8, p = 0. 02),and presence of learning disabilities (RR 2.0, 95%CI 1.2 to 3.2, p = 0.02). Having a driver’s license was associated with a higher rate of employment (RR 1.9, 95%CI 1.2 to 3.0, p =0.0002). Relapses of seizures had occurred in 37%of the 81 patients theoretically eligible for a license but only in 25%of the 52 s ubjects who actually obtained one (P = 0.003). Shortening the eligibility period from 2 to 1 year would not significantly alter the relapse rate in this populat ion. The accident rate was not increased among patients vs control subjects. Con clusions:During a long-term follow-up, differences in driving licensing betwee n patients with uncomplicated epilepsy and healthy control subjects persist desp ite legal eligibility. The lower actual relapse rates among those with epilepsy who obtain a license than in those who are eligible suggest that those at higher risk of relapse are less likely to obtain a license.