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肌阵挛与癫痫

Myoclonus and epilepsies.

作者信息

Fejerman N

机构信息

Department of Neurology, Pediatric Hospital Juan P. Garrahan Buenos Aires, Argentina.

出版信息

Indian J Pediatr. 1997 Sep-Oct;64(5):583-602. doi: 10.1007/BF02726110.

Abstract

The possible associations of myoclonic phenomenae, progressive or non-progressive encephalopathies and epileptic features are reviewed, with special emphasis on pediatric age. This leads to recognize the following five groups of conditions: (1) Myoclonus without encephalopathy and without epilepsy; (2) Encephalopathies with non-epileptic myoclonus; (3) Progressive encephalopathies presenting myoclonus seizures of epileptic syndromes (Progressive myoclonus epilepsies); (4) Epileptic encephalopathies with myoclonic seizures; (5) Myoclonic epilepsies. Within the first group, which also includes physiologic myoclonus, a more thorough description of "Benign sleep myoclonus of newborn" and "Benign myoclonus of early infancy" is given. Characteristics of group 2 are "Kinsbourne Syndrome" and certain types of "Hyperekplexia" which pose interesting differential diagnosis with stimulus-sensitive epilepsies. In group 3, the concept of progressive encephalopathies is stressed. The fourth group refers to severe epilepsies, mainly on infancy and childhood, which lead to mental retardation irrespective of their aetiology. Group 5 comprises the true myoclonic epilepsies, differentiating syndromes recognized as idiopathic--such as "Benign myoclonic epilepsy of infancy" and "Juvenile myoclonic epilepsy"--from those which are cryptogenic and carry a more cautious prognosis--as "Cryptogenic myoclonic and myoclonoastatic epilepsies" and "Severe myoclonic epilepsy of infancy". Other epileptic syndromes not usually considered as myoclonic epilepsies, but presenting sometimes as myoclonic seizures, are finally referred.

摘要

本文综述了肌阵挛现象、进行性或非进行性脑病与癫痫特征之间可能的关联,特别强调了儿童期。这使得我们能够识别出以下五组情况:(1)无脑病和无癫痫的肌阵挛;(2)伴有非癫痫性肌阵挛的脑病;(3)表现为癫痫综合征肌阵挛发作的进行性脑病(进行性肌阵挛癫痫);(4)伴有肌阵挛发作的癫痫性脑病;(5)肌阵挛癫痫。在第一组中,其中也包括生理性肌阵挛,对“新生儿良性睡眠肌阵挛”和“婴儿早期良性肌阵挛”进行了更详细的描述。第二组的特征是“金氏综合征”和某些类型的“惊跳症”,它们与刺激敏感性癫痫形成有趣的鉴别诊断。在第三组中,强调了进行性脑病的概念。第四组指的是主要发生在婴儿期和儿童期的严重癫痫,无论其病因如何都会导致智力发育迟缓。第五组包括真正的肌阵挛癫痫,将被认为是特发性的综合征——如“婴儿良性肌阵挛癫痫”和“青少年肌阵挛癫痫”——与那些病因不明且预后更为谨慎的综合征——如“隐源性肌阵挛和肌阵挛静止性癫痫”以及“婴儿严重肌阵挛癫痫”——区分开来。最后提到了其他通常不被视为肌阵挛癫痫,但有时表现为肌阵挛发作的癫痫综合征。

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