觉醒时大发作癫痫的临床和脑电图分析  

A clinical and EEG study of epilepsy with grad mal on awakening

作　　者：邓宇虹[1] 廖卫平[1] 何小诗[1] 杨少青[1] 黎冰梅[1] 宋雪祥[1] 

机构地区：[1]广州医学院第二附属医院暨广州医学院神经科学研究所,广东广州510260

出　　处：《罕少疾病杂志》2004年第3期5-8,共4页Journal of Rare and Uncommon Diseases

摘　　要：目的研究觉醒时大发作癫痫(GMA)的临床和EEG表现特点。方法对12例GMA患者的临床表现、脑电图及其治疗和预后进行回顾性分析。结果66%的患者起病年龄为6～25岁。发作均为强直-阵挛样发作,2例伴失神发作。主要的发作时间集中在清晨/中午醒后及傍晚/夜晚休息闲暇时段。多数患者无明显病因, 神经系统检查大多正常,睡眠缺乏及终止是常见的诱因。91.67%的患者间歇期EEG慢波增多,局灶性优势不明显, 25%的患者伴泛化性尖波节律及棘慢波节律。单药治疗后发作控制的有62%(5/8),4例单用丙戌酸发作可控制, 2例单用妥泰,1例有效。3例患者合并用药,发作控制>3个月。结论中国人的GMA特征与国外文献报道基本一致。丙戌酸治疗有效,妥泰治疗可能有效,单药控制不理想时,联合用药也是一个有希望的选择。Objective To study the clinical and EEG characteristics of epilepsy with gradmal on awakening (GMA).MethodsThe clinical manifestations and EEG changes, as wellas prognosis were studied in 12 patients with GMA (7males and 5 females, Aged 9months～43years).The EEG was performed in all patients.ResultsIn 66% cases, the onset age ofthe seizures was 6～25 years. The seizure type was tonic-clonic seizures in all cases, whileabsence seizure was seen in 2 cases. The majority of seizures occurred either in few hours afterawakening (early morning and noon), or during the relaxation time (night and evening). Noobvious etiological factors were found in most patients, while their neurological examinationwere also normal. The sleep deficiency and termination were common inducements. The mostfrequent findings in EEG were increased slow waves (91%), which showed no focal abnormalities.Generalized epileptic discharge (including sharp wave and spike-wave) was recorded in 25%patients. Seizures in 62%(5/12) patients were completely controlled with only one antiepilepticdrugs, four of them were controlled with valproic acid (VPA), but 1 of those relapse afterCessation of treatment. Topiramate was found effective in 1 of 2 patients. Seizures werecontrolled over 3 months in 3 patients with multiple drug therapy.ConclusionMostpatients?Character coincides with literature. VPA is effective, Topiramate may be effective.In patients when the seizures are resistant to the single drug, multiple drug would be apromising alternative.[

关 键 词：觉醒时大发作癫痫 脑电描记术 

分 类 号：R742.1[医药卫生—神经病学与精神病学] R741.044[医药卫生—临床医学]