青少年失神癫痫的电-临床研究  

Electroclinical study of patients with juvenile absence epilepsy

作　　者：魏蔚 陈文武[2] 王金香 陈蓓蓓 王晓丽 朱江 刘永红 Wei Wei;Chen Wenwu;Wang Jinxiang;Chen Beibei;Wang Xiaoli;Zhu Jiang;Liu Yonghong(Epilepsy Center,Department of Neurology,Xijing Hospital,the Air Force Medical University,Xi＇an 710032,China)

机构地区：[1]空军军医大学西京医院神经内科、脑电监测中心,西安710032 [2]河南大学第一附属医院神经内科 [3]河南大学第一附属医院

出　　处：《中华神经科杂志》2018年第9期727-731,共5页Chinese Journal of Neurology

摘　　要：目的对青少年失神癫痫的电－临床、药物治疗反应、预后等进行随访研究。方法2014年1月至2017年8月在西京医院脑电监测中心进行长程脑电监测的患者中，符合青少年失神癫痫诊断者纳入此项研究，观察项目包括起病年龄、发作类型、家族史、热性惊厥史、用药等。随访时间为6～44个月，平均（18.6±11.6）个月。结果共收集到32例患者，起病年龄5～19岁，平均（11.6±3.6）岁。5例（15.6%）患者有癫痫家族史。4例（12.5%）曾有热性惊厥史。26例（81.3%）被监测到失神发作，11例（34.4%）过度换气诱发试验阳性，5例（15.6%）间断闪光刺激诱发试验阳性。21例（65.6%）采用单药治疗，9例（28.1%）联合使用2种抗癫痫药物（AEDs），2例（6.3%）联合3种AEDs。其中最常用的AEDs是丙戊酸，其次为左乙拉西坦。在随访结束时，5例（15.6%）患者完全无发作，27例（84.4%）患者癫痫发作控制不佳。结论青少年失神癫痫的电－临床特点需要更大样本进一步总结，尽早建立详细实用的诊断标准非常必要。超过半数青少年失神癫痫患者癫痫发作控制不理想，单药治疗效果较差，往往需要联合用药。To investigate the electroclinical, treatment response and prognosis of juvenile absence epilepsy （JAE）.MethodsThirty-two patients diagnosed as JAE from Epilepsy Center of Xijing Hospital between January 2014 and August 2017 were investigated. All of them underwent 24-hour video-electroencephalography（EEG） recording. Clinical aspects, electroencephalographic features, and antiepileptic drugs （AEPs） received were reviewed. The follow-up time was 6-44 months, with an average of （18.6±11.6） months.ResultsFive patients （15.6%） had family history of epilepsy. Four patients （12.5%） had history of febrile seizures. Twenty-six patients （81.3%） showed absence seizures, 11 patients （34.4%） were hyperventilation test positive, five patients （15.6%） were intermittent flash stimulation test positive. All the 32 patients received AEDs treatments, 21 cases （65.5%） with monotherapy, nine patients （28.1%） with two AEDs, two patients （6.3%） with three AEDs. The most commonly used AED was valproic acid, and the second was levetiracetam. At the end of follow-up, five patients （15.6%） had complete seizure free and 27 patients （84.4%） had poor seizure control.ConclusionsIt is necessary to give electroclinical study on more samples of JAE and establish detailed practical diagnostic criteria about JAE as early as possible. More than half of JAE patients seizure control were not ideal. The monotherapy of JAE was less effective than combined treatment.

关 键 词：癫痫 失神性 青少年 脑电描记术 抗惊厥药 药物疗法 预后 

分 类 号：R742.1[医药卫生—神经病学与精神病学]