局灶性皮质发育不良癫痫患者的临床及脑电图特征分析  

Characteristics of clinical manifestation and EEG in focal cortical dysplasia

作　　者：蒋萍[1] 郑丽华[1] 刘沁[1] 孟桃 

机构地区：[1]宜宾市第二人民医院神经内科,四川644000

出　　处：《脑与神经疾病杂志》2018年第3期176-180,共5页Journal of Brain and Nervous Diseases

摘　　要：目的探讨局灶性皮质发育不良(FCD)癫痫患者的临床和视频脑电图(VEEG)特征。方法分析39例FCD癫痫患者的临床资料,并对患者的临床特征及VEEG结果进行分析。结果 39例患者首次癫痫发作年龄2d至23岁,平均年龄(7.49±3.32)岁,头颅MRI检查27例(69.2%)异常,12例(30.8%)阴性。术后病理按2011年ILAE制定了新的FCD分类标准,结果为FCDⅠ型13例(33.3%),Ⅱ型16例(41.0%),Ⅲ型10例(25.6%)。39例患者VEEG监测中共发作187次,平均每例4.8次,FCDⅠ型组和FCDⅡ型组发作频率高于FCDⅢ型组(P<0.05),FCDⅠ型组与FCDⅡ型组比较无明显差异(P>0.05)。发作间期6例(15.4%)FCD癫痫患者VEEG阴性,癫痫样放电区域性24例(61.5%),广泛性9例(23.1%),3型比较无明显差异(P>0.05);26例(66.7%)有节律性癫痫样放电,FCDⅡ型组高于FCDⅠ型组和FCDⅢ型组(P<0.05),FCDⅠ型组与FCDⅢ型组比较无明显差异(P>0.05)。发作期起始癫痫样放电呈区域性31例(79.5%),广泛性8例(20.5%),3型比较(P>0.05)。结论 FCD癫痫患者首次癫痫发作多见于儿童期;FCDⅠ型和FCDⅡ型临床发作频率高;发作间期具有特征性节律性癫痫样放电FCDⅡ型最多见;发作间期及发作期起始癫痫样放电主要呈区域性。Objective To identify characteristics of clinical and video electroencephalogramphic （ VEEG ） in patients with focal cortical dysplasia （FCD） . Method Prospective study of 39 patients with FCD, And to analyze the clinical characteristics and VEEG monitoring outcomes. Results The 39 patients with FCD were average age of onset of 7.49 ＋ 3.32 years. MRI in 27 cases （ 69.2 % ） were abnormalities, 12cases （ 30.8 % ） were negative. The 39 cases were redivided into different pathologic subtypes according to the new classification of FCD： 13 FCD I ,16 FCD Ⅱ, 10 FCD Ⅲ .There were a total of 187 clinical onset monitored in the 39 cases,an average of 4.8 times/cases. Seizure frequency was higher in the patients with FCD I ,or with FCD Ⅱ than in FCD ]H （ P〈0.05 ） , however, there was no significant difference between FCD I and FCD Ⅱ （ P〉0.05 ） . 6 cases （ 15.4% ） were negative during the interictal period, focal epileptiform discharges were found in 24 cases （ 61.5% ） , widespread epileptiform discharges were found in 9 cases （ 23.1% ） . There was no significant difference in three groups （ P〉0.05 ） . Interictal rhythmic epileptiform discharges were found in 26 cases （ 66.7% ）, rhythmic epilepsy epileptiform were higher in FCD Ⅱ than in FCD I and FCD Ⅲ （P〈0.05） , however, there was no significant difference between FCD Ⅰ and FCD m （ P〉0.05 ） . The starting of ictal focal epileptiform discharges were found in 31cases （ 79.5% ） , and widespread epileptiform discharges were found in 8 cases （ 20.5% ） , There was no significant difference in three groups （ P〉0.05 ） . Conclusion Epilepsy clue to FCD was common in children. Clinical seizure frequency was higher in FCD I and FCD Ⅱ; Interictal rhythmic epileptiform discharges were the most common in FCD Ⅱ; Focal epileptiform discharges on EEG was more frequently in lnterictal or ictal.

关 键 词：局灶性皮质发育不良 临床特征 脑电图 

分 类 号：R743-32[医药卫生—神经病学与精神病学]