发热感染相关性癫痫综合征3例  

Three cases of febrile infection-related epilepsy syndrome

作　　者：丁金金 赵盼 王越[1] 史丹丹[1] 刘念 麦子荆 王怀立[1] 田培超[1] Ding Jinjin;Zhao Pan;Wang Yue;Shi Dandan;Liu Nian;Mai Zijing;Wang Huaili;Tian Peichao(Department of Pediatrics,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院儿科,郑州450052

出　　处：《中华实用儿科临床杂志》2022年第2期137-139,共3页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的探讨发热感染相关性癫痫综合征的临床特点及诊治方法。方法回顾性分析郑州大学第一附属医院2019年5月至6月收治的3例发热感染相关性癫痫综合征患儿的资料,结合相关文献总结其临床特点、诊治方法及预后特点。结果3例发热感染相关性癫痫综合征患儿发病年龄为6~9岁,发热至首次抽搐时间间隔为4~7 d,于24 h内进展为癫痫持续状态,癫痫发作以多灶性发作为主,脑脊液实验室检查无异常,脑电图可见弥漫性慢波活动为背景、颞区为主的癫痫波发放,2例急性期头颅磁共振成像可见脑水肿征象。3例患儿均对多种(4~5种)抗癫痫药物耐药,接受大剂量麻醉药物治疗可有效终止癫痫持续状态。1年后随访,3例均演变为难治性癫痫,其中2例伴认知障碍,1例伴运动障碍。结论发热感染相关性癫痫综合征常见于既往体健的学龄期儿童,可由发热诱导,其癫痫发作呈爆发性、难治性,缺乏特异性实验室指标,大剂量麻醉药物可有效终止癫痫持续状态,大多预后不良。Objective To investigate the clinical features,diagnosis and treatment of febrile infection-related epilepsy syndrome.Methods The data of 3 children with febrile infection-related epilepsy syndrome admitted to the First Affiliated Hospital of Zhengzhou University from May to June 2019 were collected retrospectively,and their clinical characteristics,diagnosis,treatments and prognosis were summarized in combination with relevant literature.Results The age of onset was 6-9 years old.The time interval from fever to first convulsion was 4-7 days,and they progressed to status epilepticus within 24 hours.The seizures were mainly multifocal seizures.Cerebrospinal fluid laboratory examination was normal.Electrocardiogram shows diffuse slow wave activity as the background,and epileptic waves dominated by the temporal area.Cranial magnetic resonance imaging showed signs of edema in 2 cases during the acute phase.All patients were resistant to multiple(4-5)anti-epileptic drugs,but high-dose anesthetic drugs can effectively terminate status epilepticus.All cases developed into refractory epilepsy,2 cases had cognitive impairment and 1 case had movement impairment after 1 year.Conclusion Febrile infection-related epilepsy syndrome often occurs in school-age children who have been physically healthy,which was included by fever.The seizures are explosive and refractory in febrile infection-related epilepsy syndrome,and it lacked specific laboratory indicators.High-dose anesthetics can effectively terminate status epilepticus,but it always has a poor prognosis.

关 键 词：癫痫持续状态 难治性癫痫 发热感染相关性癫痫综合征 儿童 

分 类 号：R742.1[医药卫生—神经病学与精神病学]