左乙拉西坦治疗Jeavons综合征的临床疗效观察及其对脑电图的影响  

Therapeutic Effect of Levetiracetam on Patients with Jeavons Syndrome and Its Influence on EEG

作　　者：杨春清[1] 白利洁 李哲[1] 李攀[1] 崔雪花[1] 李文玲[1] 

机构地区：[1]河北省人民医院癫痫中心,河北省石家庄市050051 [2]耳鼻喉科

出　　处：《中国全科医学》2012年第30期3525-3527,共3页Chinese General Practice

基　　金：河北省卫生厅基金项目(20100003)

摘　　要：目的探讨左乙拉西坦(LEV)治疗Jeavons综合征的临床疗效及其对脑电图(EEG)的影响,进一步认识该病的临床和EEG特点。方法选择我院2006年5月—2011年6月诊断的7例Jeavons综合征患者,给予LEV治疗,观察治疗前后临床发作及EEG情况,了解LEV对Jeavons综合征在控制临床发作和抑制癫痫样放电(IEA)方面的作用。结果 (1)临床特点:7例患者男女比例为1∶6;平均起病年龄8岁2个月;平均病程1年11个月。全部患者眼睑肌阵挛(EM)发作表现为眼睑和眼球3～6次/s的抽动,1例只有EM一种发作形式,6例同时伴有全身强直-阵挛发作(GTCS)。(2)EEG结果:EM发作的同时EEG显示为广泛性3～6 Hz棘慢波节律,间歇期放电表现为广泛性棘波节律或4～6 Hz棘慢波节律阵发,7例闭目时放电增多,5例对闪光刺激敏感,2例过度换气时放电增多。(3)LEV的临床疗效:经过平均19.7个月治疗后,3例无GTCS,2例有效,1例加重,总有效率为83.3%(5/6);1例无EM发作,4例有效,1例无效,1例加重,总有效率为71.4%(5/7);发作间期IEA减少50.0%以上3例,减少25.0%～49.0%3例,1例放电增多;4例患者闭目放电增多现象消失,3例光敏感性下降。结论 LEV在治疗Jeavons综合征患者的临床发作、抑制IEA有一定的作用,但也有可能加重临床发作,增加IEA的可能,临床上应慎重选药。Objective To investigate the therapeutic effect of levetiracetam on patients with Jeavons syndrome and its influence on EEG to further understand the clinical manifestations and EEG features of the disease. Methods 7 patients with Jeavons syndrome admitted to our hospital from May 2006 to June 2011 were all given LEV treatment. Clinical onset and EEG before and after treatment were observed to understand the effect of LEV on the clinical onset and IEA inhibition of Jeavons syndrome. Results （ 1 ） Clinical features ： the male to female ratio of the 7 patients was 1：6 ; the average age of onset was 8 years and 2 months ; the average duration of the disease was one year and 11 months. EM seizures of all the patients showed 3 to 6 times of jerk of eyelid and eyeball, one case had EM seizure only and 6 cases had EM and GTCS seizures. （ 2 ） EEG results ： Ictal EEG showed generalized spike and waves at at 3 - 6 Hz during EM seizures ; interictal EEG showed generalized spike or generalized spike and waves discharge at 4 - 6 Hz ; 7 cases had increased epileptic discharge by eye closure ; 2 cases had increased epileptic discharge by hyperventilation; 5 cases had photosensitivity. （3） Clinical efficacy of LEV： after an average of 19.7 months treatment, 3 cases had no GTCS seizures, 2 cases were improved and one case was aggravated with an overall effective rate of 83.3% （5/6） . One case had no EM seizures, 4 cases were improved, one case was invalid and one case was aggravated with an overall effective rate of 71.4% （5/7） . During seizures, lEA decreased more than 50. 0% in 3 cases, decreased between 25.0% and 49. 0% in 3 cases and increased in one case. Epileptic discharge disappeared in 4 cases and photosensitivity decreased in 3 cases. Conclusion LEV is effective on seizure control and IEA suppression, but it can also aggravate clinical seizures and make IEA more likely to happen, thus it should be selected carefully.

关 键 词：Jeavons综合征 眼睑肌阵挛 全面强直-阵挛发作 脑电图 左乙拉西坦 

分 类 号：R742.13[医药卫生—神经病学与精神病学]