伴幻影失神的成人特发性全面性癫痫六例临床及脑电图特点  

The clinical-electroencephalographic features of the 6 patients with idiopathic generalized epilepsy in adults with phantom absences

作　　者：宋春杰[1] 孙巧英[1] 杜一星[1] 张克忠[1] 万琪[1] 

机构地区：[1]南京医科大学第一附属医院神经内科,南京210029

出　　处：《中华神经科杂志》2013年第2期78-81,共4页Chinese Journal of Neurology

摘　　要：目的描述伴幻影失神发作的成人特发性全面性癫痫6例患者的临床表现及脑电图特点。方法6例患者均于2007年4月至2011年12月就诊于我院门诊，对所有患者的临床表现、家族史、既往史、治疗情况进行详细记录，并进行多次长程或视频脑电图检查并配合计数试验检查。结果6例患者均具有相似的临床表现和脑电图特点，具体表现为：（1）意识障碍、轻微的失神发作，失神发作时脑电图表现为3．0—3．5Hz的全面性尖（棘）慢波发放（GSWD）；（2）强直阵挛发作，且多继发于失神持续状态；（3）频繁出现的失神持续状态；（4）觉醒期脑电图表现为频繁的片段化、短暂或长时间的GSWD出现，而睡眠期仅见片段化GSWD出现。所有患者均无肌阵挛及其他发作类型出现，均无光敏性。结论伴幻影失神发作的成人特发性全面性癫痫具有特征性的临床表现和脑电图特点，可能属于一种新的癫痫综合征。Objective To investigate the clinical and electroencephalogram （EEG） features of patients with idiopathic generalized epilepsy in adults with phantom absences. Methods Six patients were referred to the clinic of epilepsy from April, 2007 to December, 2011. They all had clinical assessment, EEG, or video EEG confirming absences seizure. Results Six patients showed the following similar clinical-EEG features ： （ 1 ） mild ictal impairment of consciousness associated with generalized 3.0--3.5 Hz spike and slow wave discharges; （2） late-onset generalized tonic-clonic seizures; （3） absence status epilepticus with or without secondary generalized tonic-clonic seizures; （4） generalized discharges were mostly seen in three types in the awaking stage：fragmented discharge （ 〈4 s）, brief discharge （4--10 s） and long-time discharge （ 〉 10 s ）. None of the patients had myoclonic jerks or photosensitivity. One patient＇ s mother had a history of generalized tonic clonic seizures. One patient had a history of children absence epilepsy and one patient had a history of febrile convulsion in the age of 1--3. Conclusion Idiopathic generalized epilepsy with phantom absences has distinct clinical and EEG features and may become a new idiopathic generalized epilepsy syndrome in adults.

关 键 词：癫痫 失神性 癫痫 全身性 脑电描记术 

分 类 号：R742.1[医药卫生—神经病学与精神病学]