四例Dyke-Davidoff-Masson综合征癫痫发作及视频脑电图特点  

Four cases of Dyke-Davidoff-Masson syndrome seizures and video electroencephalogram features

作　　者：李广丽 王中鸣 李振光[2] 卢军[2] 彭琼[2] LI Guangli;WANG Zhongming;LI Zhenguang;LU Jun;PENG Qiong(Clinical Medical College,Hunan University of Chinese Medicine,Changsha 410036,China;Epilepsy Center,Brain Hospital in Hunan Province,Changsha 410021,China)

机构地区：[1]湖南中医药大学临床医学院,长沙410036 [2]湖南省脑科医院癫痫中心,长沙410021

出　　处：《癫痫杂志》2023年第6期466-471,共6页Journal of Epilepsy

基　　金：湖南省临床技术创新引导项目(2018SK50604);湖南省自然科学基金(2023JJ60291)。

摘　　要：目的旨在总结Dyke-Davidoff-Masson综合征(Dyke-Davidoff-Masson syndrome,DDMS)癫痫发作及视频脑电图(Video electroencephalogram,VEEG)特点。方法回顾性分析2022年3月—2023年3月在湖南省脑科医院癫痫中心就诊的4例DDMS患者的病例资料,总结其癫痫发作的临床表现及VEEG特点。结果1例症状性癫痫,局灶性发作;VEEG表现背景活动α节律调节、调幅欠佳,左侧额、颞区慢波活动分布增多;双侧额中央、前颞区(左侧为甚),尖慢复合波发放。2例症状性癫痫,局灶性发作进展全面性发作;其中一例VEEG表现为:背景活动α节律调节、调幅可,左额、中央、前颞区慢波增多;左侧额中央、顶前颞区尖样慢波活动夹杂尖波、尖慢复合波短-中程发放;另一例VEEG表现为:背景活动α节律调节、调幅可,右额中央、前颞区慢波增多;右侧额、中央及前颞区为著中-极高等波幅慢波活动夹杂尖波、尖慢复合波呈短-中程频繁发放。1例症状性癫痫,全面性发作;VEEG表现双侧枕区节律不对称,右侧枕区<50%左侧,调节、调幅欠佳;双侧额极、额区、前颞区尖、棘慢复合波放电(右侧为著),右侧蝶骨电极、前颞、中颞尖波、尖慢波放电。结论癫痫发作为DDMS临床主要表现之一,且大多数因癫痫发作后就诊,其癫痫发作类型往往是局灶性发作或进展为全面性发作,大多数是难治性癫痫。VEEG监测结果多见背景活动异常,慢波活动增多,致痫样波放电部位多与头颅MRI所示的脑软化灶或萎缩侧部位一致。Objective The aim was to summarize the seizure and video electroencephalogram(VEEG)characteristics of Dyke-Davidoff-Masson syndrome(DDMS).Methods The case data of four patients with Dyke-Davidoff-Masson syndrome(DDMS)who attended the Epilepsy Center of Hunan Provincial Brain Hospital from March 2022 to March 2023 were retrospectively analyzed to summarize the clinical manifestations of their seizures and the characteristics of their video electroencephalogram(VEEG).Results One case of symptomatic epilepsy with focal seizures;VEEG showed poor background activity alpha rhythmic modulation,amplitude modulation,and increased distribution of slow wave activity in the left frontal and temporal regions;bilateral frontal-central and anterior-temporal regions(more so on the left side),with sharp and slow composite wave issuance.Two cases of symptomatic epilepsy with focal seizures progressing to generalized seizures;in one case,the VEEG showed:background activityα-rhythmic modulation,amplitude modulation is possible,the left frontal,central,anterior temporal region slow wave increase;the left frontal central,parietal anterior temporal region spike-like slow wave activity mixed with spike wave,spike-slow complex wave short-medium-range issuance;the other VEEG showed:background activityα-rhythmic modulation,amplitude modulation is possible,the right frontal central,anterior temporal region slow wave increase;right frontal,central,and anterior temporal region for the famous medium-extremely high-high-amplitude slow wave activity mixed with spike wave,spike-slow complex wave short-medium-range issuance.One case of symptomatic epilepsy with generalized seizures;VEEG showed bilateral occipital alpha rhythm asymmetry,right occipital region<50%of the left side,poor regulation and amplitude modulation;bilateral frontal pole,frontal region,anterior temporal region spike and spiking slow complex wave discharges(right side was prominent),and right pterionic electrodes,anterior temporal and mesial temporal spike and spiking slow wav

关 键 词：Dyke-Davidoff-Masson综合征 大脑半球萎缩 癫痫 视频脑电图 

分 类 号：R742.1[医药卫生—神经病学与精神病学]