2558例学龄期儿童癫痫的临床分析  

Clinical analysis of 2558 school-age children with epilepsy

作　　者：李军强 向开华 岳艳 卢静 宋文珺[1] 王天成[1] LI Junqiang;XIANG Kaihua;YUE Yan(Department of Neurology,the Second Hospital of Lanzhou University,Lanzhou(730000),Gansu,China)

机构地区：[1]兰州大学第二医院神经内科,甘肃兰州730000

出　　处：《癫痫与神经电生理学杂志》2022年第2期91-95,共5页Journal of Epileptology and Electroneurophysiology(China)

基　　金：甘肃省科技计划(重点研发计划21YF1FA171),兰州市科技计划项目(2018-1-11),兰州市城关区科技计划项目(2019SHFZ0023)。

摘　　要：目的探讨学龄期癫痫患儿的临床特征。方法回顾性分析2012年1月至2021年12月兰州大学第二医院收治的2558例癫痫患儿的临床资料。结果发作形式以部分性发作最常见(41.4%),有明确病因者1243例(48.6%),常见病因包括先天性脑发育异常(11.7%)、热性惊厥(10.4%)及围产期脑损伤(9.2%)等,1594例(62.3%)伴有共患病,以认知功能障碍389例(24.4%)和头痛258例(16.2%)最常见,1640例(64.1%)可以诊断为电-临床综合征,以伴中央颞区棘波的良性癫痫(BECT)432例(26.3%)、青少年肌阵挛(JME)321例(19.6%)、儿童失神癫痫(CAE)247例(15.1%)及晚发性儿童枕叶癫痫(Gastaut型)252例(15.4%)最为常见,抗癫痫药物单药以奥卡西平和左乙拉西坦使用率最高,分别占44.1%和34.7%。2323例患儿正常上学,入学率为90.8%,学习成绩中等,有共患病者学习成绩明显低于无共患病者。结论癫痫患儿发作以部分性最常见,大多病因不明或目前无法明确,最常见的综合征为BECT,单药以奥卡西平最常用,共患病是影响患儿学习的主要因素。Objective To explore clinical characteristics of school-age children with epilepsy.Methods The clinical data of 2558 children with epilepsy admitted to the Second Hospital of Lanzhou University from Jan.2012 to Dec.2021 were retrospectively analyzed.Results The most common seizure type was partial seizures(41.4%).Among all patients,1243 patients(48.6%)had definite etiology.Common etiologies included congenital encephalodysplasia(11.7%),febrile convulsion(10.4%),and perinatal brain injury(9.2%),etc.Among all patients,1594 patients(62.3%)were accompanied by comorbidities,among which,cognitive dysfunction(n=389,24.4%)and headache(n=258,16.2%)were very common comorbidities.Among all patients,1640 patients(64.1%)may be diagnosed as electro-clinical syndromes,among which,benign epilepsy with centrotemporal spikes(BECT)(n=432,26.3%),juvenile myoclonus(JME)(n=321,19.6%),childhood absence epilepsy(CAE)(n=247,15.1%)and late-onset childhood occipital epilepsy(Gastaut type)(n=252,15.4%),were very common.Oxcarbazepine and levetiracetam were the single most used antiepileptic drugs,accounting for 44.1%and 34.7%,respectively.Among all patients,2323 children went to school normally,and school enrollment rate was 90.8%.Their academic performance was moderate.Academic performance of the patients with comorbidities was significantly lower than those without comorbidities.Conclusion The partial seizures was the most common seizure type.Most of the etiologies are unknown or currently unclear.The most common syndrome is BECT.Oxcarbazepine is the most commonly used single drug.Comorbidities are the main factors affecting children's learning.

关 键 词：儿童 学龄期 癫痫 抗癫痫药物 中央颞区棘波的良性癫痫(BECT) 

分 类 号：R742.1[医药卫生—神经病学与精神病学] R971.6[医药卫生—临床医学]