儿童伴不典型失神发作的临床及脑电图特征

北京哪里治白癜风 http://www.wxlianghong.com/
儿童伴不典型失神发作的临床及脑电图特征贾桂娟，李保敏，雷革非，孙医院儿童医疗中心神经科（济南）

癫痫杂志第4卷第1期10～13

目的探讨儿童不典型失神的电-临床特征、诊断及治疗。方法对43例伴有不典型失神发作的患儿的临床及EEG资料进行分析，随访治疗效果及预后。结果患儿男24例，女19例，平均5.43岁，起病年龄1岁8个月～10岁3个月不等。43例患儿均行头颅核磁共振（MRI）检查，18例未见明确异常，25例MRI存在异常：大脑皮质发育异常、脑萎缩13例,先天性胼胝体发育不良2例，双侧壳核后部异常信号2例，脑软化灶4例，脑室扩大2例，脑积水2例。所有患儿不典型失神发作几乎都在清醒期，并均在院接受过1次以上脑电图监测，所有患儿EEG均有较慢的背景活动，不典型失神发作期均见广泛性1.5～2.8Hz棘慢波、慢棘慢复合波发放。随访所有患儿，6例患儿发作完全控制，19例患儿家长自述无发作，18例患儿治疗效果差。40例患儿存在不同程度的神经心理损伤及运动倒退，其中13例患儿发病时已有发育迟缓；27例发病前儿童认知近乎正常，患病2年后认知障碍的比例升至75%～95%。另3例患儿损伤不明确。结论伴有不典型失神发作的大多数儿童智力损害及认知障碍的发生率较高，发病年龄较小，并且呈渐进性，在发育过程中有非特异性的脑损伤。抗癫痫药物可减少临床发作,但对神经心理损伤及运动倒退改善不明显。

儿童；不典型失神；脑电图；癫痫

ClinicalandEEGcharactersticsofchildrenwithatypicalabsenceseizures

JIAGuijuan,LIBaomin,LEIGefei,SUNRuopeng.

DepartmentofNeurology,Pediatricmedicalcenter,QiluHospitalofShandongUniversity,Jinan,China

ObjectiveToinvestigatetheclinicalandEEGcharacteristics,therapeuticresponseandprognosisinchildrenwithatypicalabsenceseizures.MethodsTheclinicalandEEGdataof43childrenwithatypicalabsenceseizure

wereanalyzed,andtherapeuticresponseandprognosiswerefollowedup.

TheclinicalandEEGdataof43childrenwithatypicalabsenceseizuresinQiluHospital,ShandongUniversityduringJanuarytoDecemberwereanalyzed,andtherapeuticresponseandprognosiswerefollowedup.Allofthe43patientshadMRIexamines,and18childrenwerenormol.MRIabnormalitiesappearedin25children,includingcerebralcorticaldysplasiaandcerebralatrophy(13cases),congenitalcorpuscallosumhypoplasia(2cases),andabnormalsignalinbilateralposteriorputamen(2cases),encephalomalaciafocus(4cases),ventricleexpention(2cases),hydrocephalus(2cases).AllthechildrenunderwentEEGmorethanonce.ResultsChildrewere24maleand19femalewiththemeanageof5.43y.Theonsetageswerefrom1yearsand8monthsto10yearsand3months.Allchildrenhadatypicalabsenceseizuresduringdaytime.ChildrenhadslowlybackgroundsinretestingEEG,andspineandslowwavesof1.5Hzto2.8Hzcouldbeseeninalltheatypicalabsenceseizures.Allchildrenwerefollowedup,andexcept6childrenwith

转载请注明：http://www.hjmgt4000788781.com/njszl/8046.html