脑性瘫痪患儿合并癫痫的相关因素分析  

Analysis of Related Factors for Children with Cerebral Palsy Complicated by Epilepsy

作　　者：霍洪亮[1] 顾琴[1] 师晓燕[1] 曹徐君[1] 吉永春[1] 

机构地区：[1]苏州大学附属儿童医院神经康复科,江苏苏州215003

出　　处：《解放军医药杂志》2014年第11期72-74,78,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

摘　　要：目的探讨脑性瘫痪(cerebral palsy,CP)患儿合并癫痫的相关因素,为临床防治CP患儿继发癫痫、改善患儿预后提供参考。方法回顾性分析苏州大学附属儿童医院2006年9月—2014年2月收治的477例CP患儿的临床资料,包括一般临床资料及影像学资料,并对CP患儿继发癫痫的相关因素进行多因素Logistic回归分析。结果477例CP患儿中,86例出现癫痫发作,发生率为18.0%。86例患儿中癫痫发作类型以强直阵挛性发作为主(44.2%),其次为肌阵挛发作(29.1%);CP类型以四肢瘫最多见(61.6%)。多因素Logistic回归分析显示,出生低体重(OR=3.583,P<0.01)、颅内出血(OR=2.793,P<0.01)、脑软化(OR=5.845,P<0.01)、脑结构畸形(OR=3.184,P<0.01)是CP患儿合并癫痫的独立危险因素。结论临床对有出生时低体重、颅内出血史,影像学表现为脑软化、脑结构畸形的CP患儿应密切关注,以防继发癫痫。Objective To investigate related factors for children with cerebral palsy（ CP） complicated by epilepsy in order to provide clinical references for prevention and treatment of secondary epilepsy and improve the prognosis of cerebral palsy children. Methods Clinical data of 477 CP children during September 2006 and February 2014 was retrospectively analyzed,which included general clinical data and imaging examination data,and multiple factors of Logistic regression analysis was performed for the possible related factors in CP children with secondary epilepsy. Results Among the 477 CP children,86 children had epileptic attack,and the incidence rate was 18. 0%. The main type of epilepsy in the 86 children was tonic-clonic seizures（ 44. 2%） followed by myoclonic seizures（ 29. 1%）; quadriplegia was the most common type in the 86 children with epilepsy（ 61. 6%）. The multivariable Logistic Regression Analysis showed that independent risk factors for children with CP complicated by epilepsy were low birth weight（ OR = 3. 583,P〈0. 01）,intracranial hemorrhage（ OR = 2. 793,P〈0. 01）,softening of brain（ OR = 5. 845,P〈0. 01） and brain structural abnormalities（ OR = 3. 184,P〈0. 01）. Conclusion Children with cerebral palsy have low birth weight,intracranial hemorrhage,softening of brain and brain structural abnormalities. Close attention should be paid to those patients to prevent secondary epilepsy.

关 键 词：脑性瘫痪 儿童 癫痫 危险因素 

分 类 号：R742.3[医药卫生—神经病学与精神病学]