摘要
目的了解儿童专科医院癫痫患儿临床特征、病因、发作类型和电临床综合征分布,尝试2010年国际抗癫痫联盟(ILAE)的新癫痫分类(2005—2009)在小儿癫痫中的应用。方法制定专项调查表,收录2005年7月至2012年1月复旦大学附属儿科医院就诊的癫痫患儿资料,其中2011年8月起采用2010年国际抗癫痫联盟(ILAE)进行分析,而2011年8月前收集的患儿资料按2010年新分类进行再次分析及进一步检查。结果 (1)患病特征:1047例癫痫患儿中男∶女=1∶0.53,其中561例(53.6%)在3岁以内起病。首次发作和第2次发作的间隔时间平均数为4.72个月,967例(92.4%)第2次发作在首次发作的1年内。(2)病因分类:遗传性病因398例(38.0%)、结构性或代谢性病因388例(37.1%)、未知病因261例(24.9%)。产前和(或)围生期因素304例,占结构性或代谢性病因的78.4%;产后因素中,中枢神经系统感染因素占半数以上(46例,57.7%)。(3)癫痫类型分析:1047例癫痫患者中,全面性癫痫336例(32.1%)、局灶性癫痫355例(33.9%)、癫痫性痉挛47例(4.5%)、不能分类71例(6.8%),多种发作类型238例(22.7%)。电临床综合征:412例(39.4%)患者能够归为电临床综合征。结论低龄儿童是小儿癫痫的防治重点,癫痫复发多在首发后1年内;未知病因占1/4;局灶性发作多于全面性发作。
Objective To explore clinical features of epilepsy in children, using the newly proposed Report of the ILAE Commission on Classification and Terminology 2005-2009.Methods A questionnaire study was conducted.The chil- dren with epilepsy younger than 18 years old, recorded in our hospital from July 2005 to Janurary 2012, were include.Epi- lepsy was classified into mode of onset, etiology, and syndrome.Data was analyzed with SPSS16 （P = 0.05）.Results （ 1 ） Clinical characteristic：male 686 （65.5%）, female 361 （34.5%）, male：female = 1：0.53.The mean age of onset was 2.85 years.The onset ages of 53.6% patients were younger than 3 years; a peak age of onset was younger than 1 year old （27.5%）.Average internal of the first and second seizure was 4.72 months （1 d-95.4m）. （2）Etiology：Genetic, structur- al-metaboli, and unknown epilepsy accounted for 38.0,37.1% and 24.9%, respectively.Prenatal and （or） perinatal fac- tors were the most common causes of structural-metabolic epilepsy （78.4%）.Among all symptomatic causes, the infection of central nervous syste, accounting for 57.7% of all postnatal factors, was a major postnatal factor of epilepsy in children. （3） Seizure type： Mode of onset was focal in 33.9%, generalized/bilateral in 32.1%, spasms in 4.5% and unknown in 6.8%.Totally 412 cases （39.4%） could be classified into electroclinical syndrome.Conclusion The focus of prevention and treatment of epilepsy is infants and young children. More than 90% of the patients have recurred one year after the first attack.The unknown etiology accounts for nearly a quarter. The percent of focal seizure is more than generalized seizure.
出处
《中国实用儿科杂志》
CSCD
北大核心
2013年第9期687-690,共4页
Chinese Journal of Practical Pediatrics
关键词
癫痫
儿童
临床特征
国际抗癫痫联盟
分类
框架
epilepsy
children
clinical features
ILAE
classification
terminology
