青少年肌阵挛癫痫的预后及影响因素长期随访分析  

Prognosis and influential factors of juvenile myoclonic epilepsy .A long term follow-up analysis

作　　者：高路燕[1] 王凤楼[2] 

机构地区：[1]天津市第四中心医院神经内科,天津300140 [2]天津医科大学总医院神经内科

出　　处：《癫痫与神经电生理学杂志》2015年第3期139-142,共4页Journal of Epileptology and Electroneurophysiology(China)

摘　　要：目的：探讨青少年肌阵挛癫痫的预后。方法：对42例青少年肌阵挛癫痫患者进行3～19年长期随访，平均随访9．75年，回顾性分析该病的预后及其影响因素。结果：28例（67％）患者发作终止，21例无复发，其中无发作5年以上、10年以上分别为14例、4例。单纯肌阵挛发作（MJ）17例中，14例发作终止（82％）；MJ十全面性强直阵挛发作（GTCS）14例中，9例发作终止（64％）；MJ＋失神发作（AS）7例中，4例发作终止（57％）；MJ＋单纯部分性发作（SPS）＋GTCS4例中，3例未终止发作，1例发作减少。减药前脑电图正常者11例，2例复发（18％），异常者17例，5例复发（29％）。结论：青少年肌阵挛癫痫早期正确的诊断、正确应用抗癫痫药物，预后较好，50％的患者发作终止并可长期停药。单纯MJ预后较好，MJ＋SPS＋GTCS、MJ＋AS预后较差。减药前脑电图正常者复发率低。Objective：To explore the prognosis of patients with jurenile myoclonic epilepsy（JME）. Methods：Data from 42 patients with JME were studied during the followw-up of 3 to 19 years. The aver- age followw-up period is 9.75 years. The prognosis and influential factors of the disease were analyzed retrospectively. Results ： 28 patients （67% ） were free from seizure, of which 21 had no recurrence, inclu- ding 14 cases without seizure for more than 5 years, 4 cases for more than 10 years. Of 17 cases with MJ, 14 cases（82%） had no seizure;Of 14 cases with MJ＋GTCS,9 cases （64%） had no seizure;Of 7 cases with M J＋ AS, 4 cases （57 %） had no seizure （57 %） ; Of 3 cases with MJ ＋SPS＋GTCS, no case was from seizure free, 1 case had seizure reduction. EEG were recorded in 28 cases of seizure-free patients before reducing drugs, 11 cases were normal, 2 cases （18 % ） got recurred; 17 cases were abnormal, 5 cases （29 %） got recurred. Conclusion： The prognosis of patients with JME is effective for if drags are properly applied,50% patients with longw-term withdrawal seizure free and. The prognosis of pure MJ is better, while MJ＋SPS＋GTCS, MJ＋AS had bad prognosis. Patients with normal EEG before reducing drugs have low recurrence rate.

关 键 词：青少年肌阵挛癫痫(JME) 预后 

分 类 号：R742.1[医药卫生—神经病学与精神病学]