摘要
目的分析不同类型儿童癫痫持续状态（SE）的临床和脑电图（EEG）特征，以期对SE作出早期诊断及处理。方法用录像脑电图监测的方法对1996年3月至1999年3月北京医科大学第一医院儿科（24例）和香港大学儿科部（3例）收治的27例癫痫SE患儿按发作类型进行分类，分析不同类型的临床发作特征及年龄、病因、脑发育水平、诱发因素和药物反应等对SE的影响。结果本组27例SE患儿中强直-阵挛性SE1例，强直性SE2例，肌阵挛性SE4例，失张力性SE1例，典型失神性SE1例，不典型失神性SE5例，简单部分性SE5例，复杂部分性SE7例，一侧性SE1例。病因学分类：本组27例中症状性癫痫18例，隐源性癫痫7例，特发性癫痫2例。27例中9例既往有SE史，2例SE患儿为首次发作；17例本次SE前即有智力发育落后；22例在本次SE发生前1周内每日癫痫发作频率＞10次。本组SE患儿的可能诱因为：停用抗癫痫药物8例，急性非中枢神经系统感染6例，低钙血症1例。症状性癫痫的起病年龄和发生SE的年龄明显早于隐源性和特发性阗痫组。在同一类型的SE中，不同病因可表现为不同的临床与EEG特征。11例（11／13）患儿静脉注射氯硝基安定（CZP）后可有效控制SE。结论SE的临床和EEG特征与年龄、脑发育水平、病因及癫痫综合征有密切关系。SE的临床发作及EEG的癫?
Objectives To analyse the clinical and EEG features of various types of status epilepticus (SE) in childhood in order to recognize and manage SE in the early stage. Methods The types of SE confirmed by video-EEG in 27 chidren were classified basing on seizure types. The effects of ages, etiology, brain developmental levels, provoked factors and responses to antiepileptic drugs (AED) on SE were analysed. Results This group included most types of SE. There were 18 patients with symptomatic epilepsy, 9 with history of SE,and 2 with recenf SE as the first epileptic seizure. Seventeen children had neurodevelopmental delayed occurrence prior to SE. The seizure frequency was more than 10 times a day in 22 children. Potential causes of SE were with drawing AED in 8 cases, acute non-central system infection in 6 cases and hypocalcemia in as case. The onset of epilepsy and SE were significantly earlier in children with symptomatic epilepsy than those with cryptogenic or idiopathic epilepsy(P<0.05). The clinical and EEG features were different depending on various etiologies in spite of having the same SE type. Intra venous injection of clonizepame was effcient to control SE in 11 of the 13 patients. Conclusions The clinical and EEG features of SE were closely related to the ages of SE, the brain developmental levels, the etiology and epileptic syndromes. Most of SE had fluctuated clinical symptoms and EEG patterns. The high risk factors suggested developing SE included symptomatic epilepsy, neurodevelopment delay,markedly increased seizure frequency, suddenly changing or withdrawing of AED, complicating infection and metabolic disturbance. Intra venous injection of clonizepame had rapid and obvius effect on inhibiting abnormal discharges and improving clinical symptoms, and may help to diagnose nonconvulsive SE.
出处
《中华神经科杂志》
CAS
CSCD
2000年第2期73-76,共4页
Chinese Journal of Neurology
