线粒体脑肌病伴高乳酸血症及卒中样发作综合征患者癫痫发作临床特征分析  

Epileptic seizures and electroencephalographic findings in patients of mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes

作　　者：杨西爱[1] 陈涛[1] 李德帅 刘毅[1] 

机构地区：[1]陕西省安康市中心医院神经内科,725000 [2]陕西省西京医院神经内科

出　　处：《中国医师进修杂志》2016年第3期229-231,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的分析线粒体脑肌病伴高乳酸血症及卒中样发作（MELAS）综合征患者癫痫发作的临床特征。方法回顾性分析55例MELAS综合征患者的临床资料，对患者卒中样发作期和非发作期癫痫发作类型及脑电图特征进行分析。结果MELAS综合征患者癫痫发作率为89．1％（49／55），其中发作类型≥2种33例。卒中样发作期癫痫简单部分性发作、全面性强直阵挛发作以及癫痫持续状态发生率均明显高于非发作期[47．3％（26／55）比12．7％（7／55）、69．1％（38／55）比27．3％（15／55）和38．2％（21／55）比5．5％（3／55）]，差异有统计学意义（P〈0．05或〈0．01）。MELAS综合征患者脑电图均存在异常改变，卒中样发作期脑电图仪波频率变慢发生率明显低于非发作期[7．3％（4／55）比30．9％（17／55）]，差异有统计学意义（P〈0．05）。结论MELAS综合征患者在卒中样发作期内各种类型癫痫发作均较非发作期显著增多，但癫痫波在非发作期同样常见。Objective To investigate the features of epileptic seizures and eletroencepalogram （EEG）in patients of mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes （MELAS）. Methods Fifty-five patients with MELAS were selected. EEG and head MRI was performed on all patients.The types of epileptic seizure and EEG changes were compared between patients in and outside stroke-like episodes. Results Epileptic seizures occurred in 49 of 55 patients （89.1%） with MELAS, while muhitype epileptic seizures were presented in 33 cases（67.3%）. The frequency of partial seizures, generalized tonic-clonic seizures, status epilepticus was 47.3% （26/55）, 69.1% （38/55）, 38.2% （21/55） in stroke-like episodes and12.7%（7/55）, 27.3%（15/55）, 5.5%（3/55） in nonstroke-like episodes, which had statistical significance （χ2 = 8.023, 10.647, 11.002; P = 0.022, 0.016, 0.005, respectively）. Abnormal EEGs appeared in all patients.The rates of slow alpha frequency, diffuse 8 or 0 wave, epileptic discharges were 7.3%（4/55）, 43.6%（24/55） and 25.5%（14/55） in stroke-like episodes and 30.9%（17/55）, 58.2% （32/55） and 23.6% （13/55） in nonstroke-like episodes, respectively.Slow alpha frequency was significandy different between patients in and outside stroke-like episodes （χ2= 8.933, P= 0.019）. Conclusions Epileptic seizures with different types are more common during stroke-like episodes in patients with MELAS.While the rates of epileptic discharges are also common outside the stroke- like episodes.

关 键 词：MELAS综合征 癫痫 脑电描记术 回顾性研究 

分 类 号：R596[医药卫生—内科学] R747.9[医药卫生—临床医学]