临床儿科杂志 ›› 2018, Vol. 36 ›› Issue (5): 376-.doi: 10.3969/j.issn.1000-3606.2018.05.014

• 综合报道 • 上一篇    下一篇

儿童惊吓性癫痫脑电图及临床特征

罗小青, 李承, 匡光涛, 梁菊芳, 余晓莉, 王晓璐, 江军   

  1. 华中科技大学同济医学院附属武汉儿童医院神经电生理室(湖北武汉 430000)
  • 收稿日期:2018-05-15 出版日期:2018-05-15 发布日期:2018-05-15
  • 通讯作者: 江军 E-mail:jingjunzm@163.com
  • 基金资助:
    武汉市卫计委青年项目(No.WXITQ26);湖北省自然科学基金项目(No.2016CFC729)“十二五”国家科技支撑计 划项目(No.2013BAI02B07)

Electrophysiological and clinical characteristics of children with startle epilepsy

 LUO Xiaoqing, LI Cheng, KUANG Guangtao, LIANG Jufang, YU Xiaoli, WANG Xiaolu, JIANG Jun   

  1. Department of electrophysiology, Wuhan Children's Hospital, Tongji Medical, Huazhong University of Science & Technology Wuhan 421000, Hubei, China
  • Received:2018-05-15 Online:2018-05-15 Published:2018-05-15

摘要: 目的 探讨儿童惊吓性癫痫发作期、发作间期脑电图及临床特征。方法 回顾分析2012年6月-2016年3月 确诊的8例惊吓性癫痫患儿的临床资料。结果 8例患儿中男3例、女5例,起病年龄2.3~8.1岁。肌阵挛发作3例,失张力 发作2例,轻微强直发作、不对称性姿势性强直及痉挛发作各1例。发作期脑电图5例表现为广泛性电压衰减;发作间期脑 电图多表现为大量多灶、广泛性棘波、棘慢波、多棘慢波发放。 7例患儿有脑部损伤病史。 7例患儿影像学异常,多为额、顶、 颞区病变,以局部脑软化、脑萎缩多见。 7例患儿存在智力运动发育落后或倒退, 1例认知功能基本正常。 7例患儿经多种抗 癫痫药物治疗效果不佳, 1例经丙戊酸钠治疗2个月后无临床发作。结论 惊吓性癫痫多为症状性癫痫,既往有脑部损伤 病史,常存在大脑结构异常,发病前已存在一定程度智力、运动功能落后,抗癫痫药物疗效不佳。

Abstract: Objective To investigate the characteristics of ictal and interictal electroencephalogram (EEG) and clinical manifestation in children with startle epilepsy. Methods The age of onset, inducing factors, the types of attacks, EEG features, cognitive function, treatment and prognosis were retrospectively analyzed in 8 cases of children with startle epilepsy from June 6, 2012 to March 2016. Results In 8 cases, 3 cases were male and 5 were female. The onset age was from 2.3 to 8.1 years old. The forms of onset were varied from generalized (tonic, myoclonic, atonic) to partial seizures (the asymmetry of posture rigidity, spasm). The most common ictal EEG finding was a diffuse electrodecremental pattern (5 cases), and the interictal EEG showed a large number of multifocal, generalized spines, slow waves and multiple spinous waves. There was one case with no history of brain injury while the other 7 cases had a history of brain injury. There were 7 cases with imaging abnormality, and the lesions of the frontal, parietal and temporal regions were indicated with a partial cerebral softening and brain atrophy. In 7 cases, all children had abnormal mental and motor development, and 1 case had normal cognitive function. The 7 cases with shock epilepsy showed no obvious response to the treatment of multiple antiepileptic drugs, and 1 case had no clinical onset after 2 months of treatment with VPA. Conclusions Startle epilepsy is mostly symptomatic, and few are non-symptomatic. The former had history of brain structure abnormalities, certain degree of motor retardation and mental disability, and no clinical response to antiepileptic drug therapy. The latter had basically normal cognitive function, and antiepileptic drug VPA treatment is effective. The degree of interictal epileptic was not an indicator of cognitive impairment and prognosis in children with startle epilepsy.