临床儿科杂志 ›› 2016, Vol. 34 ›› Issue (4): 278-.doi: 10.3969 j.issn.1000-3606.2016.04.009

• 综合报道 • 上一篇    下一篇

口周肌阵挛伴失神2 例临床和脑电图分析

王晓雨, 卢孝鹏, 陈静   

  1. 南京医科大学附属南京儿童医院(江苏南京 210008)
  • 收稿日期:2016-04-15 出版日期:2016-04-15 发布日期:2016-04-15

The clinical features and electroencephalographic characteristics of perioral myoclonia with absences in 2 cases

WANG Xiaoyu, LU Xiaopeng, CHEN Jing   

  1. Nanjing Children’s Hospital Affiliated to Nanjing Medical University, Nanjing 210008, Jiangsu, China
  • Received:2016-04-15 Online:2016-04-15 Published:2016-04-15

摘要: 目的 探讨口周肌阵挛伴失神( POMA)的临床特点、脑电图特征及治疗。方法 回顾2 例POMA患儿的临床表现、脑电图特征及治疗效果,并结合文献进行分析。结果 2例患儿均以热性惊厥起病,发作表现为口周肌肉节律性抽动,伴有失神、意识障碍,发作次数较频繁,每次持续数秒至10 s。发作期脑电图特征为广泛性3 Hz 棘慢波、慢波阵发,发作间期脑电图特征为中- 极高波幅棘慢波、慢波散发或短阵发放。头颅影像学均正常,1 例智力、运动发育稍落后,1 例有癫痫家族史。2 例患儿均予丙戊酸钠治疗,服药后均能控制发作,其中1 例停药后复发。结论 POMA是以失神发作伴突出的口周肌阵挛为特征的特发性全面性癫痫综合征,视频脑电图对明确诊断有重要价值。

Abstract: Objective To investigate the clinical features, electroencephalographic (EEG) characteristics, and treatment of perioral myoclonia with absences (POMA). Methods The clinical features, EEG characteristics, and treatment in two pediatric patients with POMA were retrospectively analyzed. The related literatures were reviewed. Results In two pediatric patients POMA were onset with febrile convulsion. The clinical features were that perioral muscles were contracted rhythmically accompanied by absence and disturbance of consciousness. The episodes were frequent, each lasting a few to 10 seconds. The EEG characteristics during attack phase were generalized discharges of 3 Hz spikes and wave burst, while during interictal phase they were medium-high amplitude spine-slow waves, slow wave dissemination or short array. Brain MRIs were normal. One patient had slightly delayed mental and motor development. One patient had a family history of epilepsy. Both of them were treated with sodium valproate and the seizure was controlled. However, one patient relapsed after drug withdrawal. Conclusions POMA is an idiopathic comprehensive epilepsy syndrome featured by perioral myoclonus with absence. The video-EEG is of great value in diagnosis.