轻度胃肠炎伴婴幼儿惊厥128例脑电图改变及随访  

Electroencephalography and follow-up of 128 cases of infantile convulsions with mild gastroenteritis

作　　者：路新国[1] 廖建湘[1] 韩春锡[1] 陈彦[1] 魏雪梅[1] 徐雅娜[1] 胡雁[1] 

机构地区：[1]深圳市儿童医院神经内科暨癫痈治疗中心,518026

出　　处：《中国小儿急救医学》2013年第3期280-282,共3页Chinese Pediatric Emergency Medicine

基　　金：深圳市科技局项目（201103136）

摘　　要：目的了解轻度胃肠炎伴婴幼儿惊厥患儿惊厥发作期及发作间期的脑电图改变，并通过追踪随访了解此类患儿的脑电图演变及惊厥复发情况。方法对2005年1月至2009年12月我院神经内科住院治疗的轻度胃肠炎伴婴幼儿惊厥患儿的临床资料进行回顾性分析，进行电话或门诊随访3—7年，了解患儿惊厥发作情况。结果（1）128例患儿中，胃肠炎急性期惊厥发作间期脑电图128份，发作期脑电图4份（共5次）。其中63例发作间期脑电图未见癫癎样波发放，65例于不同导联见少许癫癎样波发放，48／65例位于中央及中央中线位置。在5次发作期脑电图中，2次发生于同一患儿的同一次监测过程中，异常波均起源于局部且起源部位不固定。2个月后脑电图复查57例，52例癫癎样波消失，其他5例仍可见少量的癫癎样波发放。（2）128例患儿在随访中失访25例，96例无发作，3例以发热为诱因出现惊厥发作，2例又在胃肠炎期间再次出现惊厥发作，未予抗癫癎治疗，1．5—3．0年未再发作，2例出现数次不明原因的无热惊厥，诊断为癫癎并给予了抗癫癎治疗，现1．5—2．5年时间暂无发作。结论（1）轻度胃肠炎伴婴幼儿惊厥患儿在胃肠炎急性期惊厥发作间期脑电图近半数可见癫癎样放电，且放电部位多在中央区及其中线；（2）发作期脑电图均局部起源；（3）轻度胃肠炎伴婴幼儿惊厥患儿有惊厥再发的危险，尤其是存在诱发因素情况下，个别患儿可转化为癫癎。Objective In present study, we aimed to investigate the ictal and interictal electroenceph- alography （EEG） changes in patients with infantile convulsions with mild gastroenteritis ,to understand the evolution of EEG and recurrence of convulsion by follow-up. Methods In this retrospective study, all patients with infantile convulsions with mild gastroenteritis visited our hospital from January 2005 to December 2009 were included, and were followed up for 3 to 7 years. All their clinical data were summarized and analyzed. Results Fist of all,we collected 128 interictal EEGs and 4 ictal （5 episodes） reports. Based on interictal EEGs, no discharge was observed in 63 subjects, and epileptic waves were discovered in other 65 patients. In most cases （48/65） epileptic waves were found to be located in the central area. For all 5 recorded ictal EEGs （2 were from same patient ）, epileptic waves were originated from different regions. Two months later, epileptic waves disappeared in 52/57 cases,but there were still discharge in 5 cases. Secondly,in the 103 cases who were successfully followed up,96 were seizure free,5 had recurrence during fever （3 cases） or gas- troenteritis （2 cases） ,but remained seizure free for last 1.5 to 3.0 years. Overall ,convulsion was recurred in 2 cases and finally diagnosed as epilepsy and then treated with antiepileptic drug, keeping seizure free for recent 1.5 to 2. 5 years. Conclusion （ 1 ） Discharge can be found in nearly half of interictal EEGs in cases with infantile convulsion with mild gastroenteritis ,and most of them are located in central region. （2） All discharge come from local origin in ictal EEGs. （3） Seizure may recur in cases with infantile convulsion with mild gastroenteritis, especially in the presence of causative factors. Some children have risk of developing epilepsy.

关 键 词：胃肠炎 脑电图 惊厥 癫癎 婴幼儿 

分 类 号：R742.1[医药卫生—神经病学与精神病学]