局灶运动抑制性发作5例患儿临床特征及脑电图分析  

Clinical features and electroencephalographic characteristics of focal inhibitory motor seizure

作　　者：王诗雨 赵绚 李婷 朱小颖 张礼萍[1] 戚小红[1] WANG Shi-yu;ZHAO Xuan;LI Ting(Department of Pediatric,Xuanwu Hospital of Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院儿科,北京100053

出　　处：《中国实用儿科杂志》2021年第7期508-513,共6页Chinese Journal of Practical Pediatrics

摘　　要：目的探讨局灶运动抑制性癫痫儿童的临床及电生理特点,提高对此类癫痫的认识。方法回顾性分析2015年1月至2019年4月首都医科大学宣武医院儿科住院收治的5例有局灶运动抑制性癫痫患儿脑电图特点、临床特征和治疗情况。结果 5例患儿中男4例、女1例,起病年龄从2岁3月龄至9岁不等,5例均表现为一侧肢体无力,发作期间意识清楚,2例伴感觉异常,1例出现言语不能,持续时间数秒至十分钟不等。4例脑电图可见对侧中央、顶、颞为主导联异常放电,1例脑电图未监测到痫样放电,进一步行脑磁图可见对侧中央区少量棘波。1例头颅核磁共振发现右侧顶叶皮质胶质神经元肿瘤。2例给予奥拉西平治疗后无发作,1例给予左乙拉西坦治疗后发作减少(随访5年无发作),2例出现加用奥卡西平过程中出现药物过敏,1例手术评估后行癫痫手术治疗,1例行肿瘤切除术,术后发作明显减轻。结论局灶运动抑制性癫痫较少见,易被误诊或漏诊,需提高临床对该病的认识,早期诊断并给予有效治疗。Objective To investigate the clinical and electroencephalographic characteristics of focal inhibitory motor seizure in children in order to improve the understanding of this disease.Methods The EEG characteristics,clinical manifestations,treatment and outcome of 5 children with focal inhibitory motor seizure were retrospectively analyzed.ResultsAmong the 5 cases,there were 4 males and 1 female,onset age ranging from 2 years and 3 months to 9 years.All children present with paralysis of one side of the body,awareness was retained,2 children had parethesia,and 1 child had aphasia.The seizures often lasted from a few seconds to ten minutes.4 patients were observed epileptiform EEG abnormalities in the contralateral central,parietal and temporal region.1 patient was normal in EEG,but the further magnetoencephalography showed that spikes were in contralateral central region.The glioneuroma in the right parietal cortex was found by MRI in 1 patient.Two patients were controlled with oxcabazepine,1 patient was treated with levetiracetam and there was fewer seisures after treatment(no attack in the 5-year follow-up).Two patients were allergic to oxcabazepine,one received epilepsy surgery and one received tumor resection;the seizures were controlled after surgery.Conclusion Focal inhibitory motor seizure is rare and it is easy to be misdiagnosed or missed.It is necessary to improve clinical understanding of the disease for early diagnosis and effective treatment.

关 键 词：局灶运动抑制性癫痫 临床特点 脑电图特征 

分 类 号：R72[医药卫生—儿科]