Suárez-Moro R, Salas-Puig J, Mateos V, Amorín M, Lahoz C H
Servicio de Neurología, Hospital General de Asturias.
Neurologia. 2000 Mar;15(3):109-13.
It is known the presence of sudden falls or epileptic drop-attacks (DA) in patients with partial epilepsy.
To review the clinical and electroencephalographic manifestations in our patients with partial epilepsy and DA.
Fifteen patients (9 males/6 females) over 18 years with partial epilepsy and epileptic falls were selected.
The mean age was 39 years (24-56 years). The mean age at seizure onset were 13 years (8 months-49 years) for partial seizures and 26 years (2-54 years) for DA. Secondary generalized or not, all patients had complex partial seizures, associated with simple partial seizures in five (34%). All were treated with politherapy, but a good control was not achieved. EEG recordings showed frontal focus in 7, temporal focus in 8, secondary bilateral synchrony in 9, and increase of electroencephalographic abnormalities during sleep in 9. Cognitive and emotional disorders were observed in 8 and 6 patients, respectively. Nine patients suffered from status epilepticus. The causal lesions were connatal encephalopathy in 8 and criptogenic in the other 7. The main consequence of DA was recurrent craneal trauma in 9 patients.
The presence of DA is considered an ominous change in the evolution of a partial epilepsy. It's associated with mental deterioration and emotional disturbances and with drug resistance.
已知部分性癫痫患者中存在突然跌倒或癫痫性跌倒发作(DA)。
回顾我们的部分性癫痫伴DA患者的临床和脑电图表现。
选取15例18岁以上的部分性癫痫伴癫痫性跌倒患者(9例男性/6例女性)。
平均年龄为39岁(24 - 56岁)。部分性发作的平均起病年龄为13岁(8个月 - 49岁),DA的平均起病年龄为26岁(2 - 54岁)。无论是否继发全面性发作,所有患者均有复杂部分性发作,其中5例(34%)伴有简单部分性发作。所有患者均接受多种药物治疗,但未取得良好控制。脑电图记录显示7例为额叶病灶,8例为颞叶病灶,9例为继发性双侧同步性,9例在睡眠期间脑电图异常增加。分别有8例和6例患者观察到认知和情感障碍。9例患者发生癫痫持续状态。病因性病变8例为先天性脑病,另7例为隐源性。DA的主要后果是9例患者反复发生颅脑外伤。
DA的存在被认为是部分性癫痫演变中的不祥变化。它与精神衰退、情感障碍以及耐药性有关。