良性婴儿癫痫的临床及发作期脑电图特征  

Clinical and ictal EEG features in benign infantile epilepsy

作　　者：马秀伟[1] 侯豫[1] 辜蕊洁[1] 何芳[1] 王三梅[1] 封志纯[1] 

机构地区：[1]北京军区总医院附属八一儿童医院儿童神经发育科,100700

出　　处：《中华临床医师杂志（电子版）》2013年第22期17-20,共4页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的进一步阐述良性婴儿癫痫(BIE)的临床发作及发作期脑电图(EEG)特征,以便早期识别此病,合理治疗及评估预后。方法对21例符合BIE诊断标准的患儿临床发作及视频脑电图(VEEG)进行分析,并对治疗及预后进行随访。结果患儿发病年龄3～11个月。19例发作初期有丛集性特点。主要表现形式为:头、眼歪斜,面肌、眼睑或肢体阵挛,肢体肌张力增高或四肢松软,意识丧失,活动停止,青紫,反应迟钝,凝视,自动症。所有患儿发作间期EEG正常。13例VEEG监测到19次发作,显示发作期放电均为局灶起源,2例5次发作为左侧后颞区起源,3例4次发作为左侧中颞区起源,2例3次发作为右侧中颞区起源,3例4次发作为左枕区起源,1例1次发作为右枕区起源,左右顶区起源各1例。痫样放电持续时间55～126 s。所有患儿均单药治疗,左乙拉西坦11例,德巴金糖浆9例,奥卡西平1例,17例于1个月内发作控制。疗程1年,随访时间2～3年,无1例复发,患儿精神运动发育正常。结论 BIE丛集性发作突出;发作期EEG以颞区放电为主;此病预后良好,可缩短抗癫痫疗程。Objective To further clarify clinical features and ictal electroencephalographic findings of patients with benign infantile epilepsy（BIE） in order to early recognize and evaluate prognosis. Methods The clinical information, video electroencephalogram（VEEG） characteristics, treatment and prognosis of 21 patients fulfilled the definition of BIE were collected and analyzed. Results The onset age of seizures was from 3 months to 11 months in 21 cases. Clusters of seizures occurred in 19 patients. The seizures were characterized by motion arrest, decreased responsiveness, cyanosis, staring or mild convulsive movements, such as eye deviation, head rotation, clonic movements, or increased limb tone. Interictal EEGs were normal in all patients. Ictal discharges at the onset of a seizure were focal in all seizures. The site of the origin of seizures was in the temporal area in 12 of 19 seizures, whereas it was in the occipital area in 5 seizures and parietal region in 2 seizures. The duration of a seizure on EEG was 55 to 126 seconds. All patients were treated with antiepileptic drugs（11 with levetiracetam, nine with depakine syrup, and 1 with oxcarbazepine）. Seizures disappeared within one month in 17 patients. Antiepileptic treatment was withdrawn after 1 year and none of them experienced recurrence of seizures. All patients showed normal psychomotor development at the end of follow up. Conclusions Clusters of seizures often occur in BIE patients. The most frequent site of the seizure origin is in the temporal

关 键 词：癫痫 婴儿 发作 脑电图 

分 类 号：R742.1[医药卫生—神经病学与精神病学]