儿童额叶癫痫发作期视频脑电图分析及其与临床预后的关系  

Analysis of Video EEG during Frontal Lobe Epilepsy in Children and Its Relationship with Clinical Prognosis

作　　者：吴成念 WU Chengnian(Epilepsy Center of Liupanshui People’s Hospital,Liupanshui 553000,Guizhou Province,China)

机构地区：[1]六盘水市人民医院癫痫中心,贵州六盘水553000

出　　处：《中国实用乡村医生杂志》2023年第8期24-27,共4页Chinese Practical Journal of Rural Doctor

摘　　要：目的探讨儿童额叶癫痫发作期的视频脑电图异常波形分布及其与预后的关系。方法回顾性收集2017年1月—2022年12月六盘水市人民医院收治的额叶癫痫患儿131例,根据视频脑电图提示的癫痫发作部位,分析其临床表现发生情况;并对影响预后的不良因素进行分析。结果偏转性强直、姿势性强直、怪异动作在背外侧额部与近中央额部发生率较高;发声在背外侧额部、眶额部发生率较高;手足自动症在背外侧额部发生率较高;情绪症状在眶额部发生率较高;而局部阵挛、口咽自动症在背外侧额部、近中央额部、眶额部发生率较为接近。预后不良患儿病程长、发作频次高、脑电图分级比例高,与预后良好患儿比较,差异有统计学意义(P<0.05)。多因素回归分析显示,病程、发作频次和脑电图分级是癫痫患儿预后不良的危险因素(P<0.05)。结论儿童额叶癫痫发作期常见临床表现包括:偏转性强直、姿势性强直、怪异动作、局部阵挛、口咽自动症、发声、手足自动症、情绪症状,不同表现与病变部位存在一定关系;病程长、发作频繁、脑电图分级高是不良预后的独立危险因素。Objective To explore the distribution of abnormal waveform of video EEG during frontal lobe epilepsy in children and its relationship with prognosis.Methods A retrospective study was conducted on 131 children with frontal lobe epilepsy admitted to Liupanshui People’s Hospital from January 2017 to December 2022.The clinical manifestations were analyzed based on the location of epilepsy indicated by video EEG.And the adverse factors that affect prognosis were analysed.Results The incidences of deflective rigidity,postural rigidity,and strange movements were higher in the dorsolateral and proximal frontal regions.The incidence of vocalization was higher in the dorsolateral frontal and orbitofrontal regions.The incidence of hand and foot automatism is relatively high in the dorsolateral frontal region.The incidence of emotional symptoms in the orbitofrontal region was relatively high.The analized incidences of local clonus and oropharyngeal automatism were relatively similar in the dorsolateral frontal region,near central frontal region,and orbitofrontal region.Children with poor prognosis had a longer course of disease,higher frequency of seizures,and a higher proportion of EEG grading,with statistically significant differences compared to those with good prognosis(P<0.05).Multivariate regression analysis showed that course of disease,frequency of seizures,and EEG grading were risk factors for poor prognosis in children with epilepsy(P<0.05).Conclusion The common clinical manifestations of frontal lobe epilepsy in children during seizures include:deflective rigidity,postural rigidity,strange movements,local clonus,oropharyngeal automatism,vocalization,hand foot automatism,and emotional symptoms.Different manifestations are related to the location of the lesion.Long course,frequent seizures,and high EEG grading are independent risk factors for poor prognosis.

关 键 词：癫痫 额叶 发作期 小儿 视频脑电图 预后 

分 类 号：R725[医药卫生—儿科]