新疆地区青少年肌阵挛性癫痫的回顾性分析  

Retrospective analysis of juvenile myoclonic epilepsy in Xinjiang

作　　者：景世文 杨俊 武晨[1] 张为良[1] 任军 JING Shi Wen;YANG Jun;WU Chen;ZHANG Weiliang;REN Jun(Department of Neurology,General Hospital of Xinjiang Military Region,Urumqi 830000,China)

机构地区：[1]新疆军区总医院神经内科,乌鲁木齐830000

出　　处：《癫痫杂志》2022年第3期222-226,共5页Journal of Epilepsy

基　　金：陆军后勤面上项目(GLJ6J004)。

摘　　要：目的 回顾性分析新疆维吾尔自治区青少年肌阵挛性癫痫(Juvenile myoclonic epilepsy,JME)的流行病学、临床特点、误诊原因等,为提高当地JME的诊疗水平提供依据。方法 回顾性分析新疆维吾尔自治区癫痫患者979例,其中男515例、女464例,平均年龄(18.66+8.31)岁,分析JME的流行病学、临床特点、脑电图、治疗效果及预后等,分析误诊、漏诊及延误治疗的原因。结果 979例癫痫患者中JME的比例为1.4%,共14例,中位发病年龄为(15+5.83)岁,发病至就诊中位时间为3年,发病至确诊时间中位时间为6年。所有患者均表现为肌阵挛发作,13例合并全身强直阵挛发作,4例伴有失神发作。脑电图检查结果包括正常的背景活动,在觉醒开始时有3~6 Hz的全面性棘波或额叶优势的多棘波。7例使用左乙拉西坦治疗效果良好,另7例使用拉莫三嗪和/或丙戊酸钠治疗有效。病史采集不全及未能详描述病史是延误诊断的主要原因。结论 JME是药物治疗有效,但易误诊的疾病,新疆地区JME误诊及漏诊率较高,延误诊治时间较长。较详细的、演示性的病史问诊对提高诊断准确率有重要意义。Objective To retrospectively analyze the epidemiology,clinical characteristics and causes of misdiagnosis of Juvenile myoclonic epilepsy(JME) in Xinjiang Uygur Autonomous Region,so as to provide basis for improving the diagnosis and treatment of JME.Methods 979 patients with epilepsy in Xinjiang Uygur Autonomous Region were analyzed retrospectively.There.were515males and 464females,average.age(18.66+8.31)years,.The epidemiological characteristics of JME were analyzed.The clinical characteristics,EEG,treatment effect and prognosis of patients diagnosed with JME were analyzed.The causes of misdiagnosis,missed diagnosis and delayed treatment were analyzed.Results The proportion of JME in 979 patients with epilepsy was 1.4%,a total of 14 cases.The median age of onset was(15+5.83) years,the median time from onset to treatment was 3 years,and the median time from onset to diagnosis was 6 years.All patients showed myoclonic seizures,13 cases were complicated with generalized tonic clonic seizures,and 4 cases were accompanied by absence seizures.EEG findings include normal background activity,3-6 Hz generalized spikes or frontal dominant multiple spikes at the beginning of arousal.seven patients were treated with levetiracetam,and the other seven patients were treated with lamotrigine and/or sodium valproate.Incomplete collection of medical history and failure to describe the medical history in detail are the main reasons for delaying diagnosis.Conclusion Juvenile myoclonic epilepsy is an treatable disease,but it is easy to be misdiagnosed.The rate of misdiagnosis and missed diagnosis of JME in Xinjiang is higher,and the delay of diagnosis and treatment is longer.The inquiry of more detailed and demonstrative medical history is of great significance to improve the diagnostic accuracy.

关 键 词：癫痫 青少年肌阵挛癫痫 失神发作 肌阵挛发作 强直阵挛发作 

分 类 号：R742.1[医药卫生—神经病学与精神病学]