Ozawa T, Nakashima Y, Ito R, Hirano A, Kondo T
Department of Pediatrics, Ogaki Municipal Hospital, Ogaki, Gifu.
No To Hattatsu. 2001 Jan;33(1):63-8.
We reported here a case of symptomatic partial epilepsy following acute necrotizing encephalopathy of childhood associated with influenza A virus infection. This 2-year-old boy underwent repeated EEG recordings, which at the acute stage was dominated by diffuse 1-2 Hz slow waves. The background activity was 5 Hz theta waves on the 49th day. Paroxysmal activities appeared after the 89th day of illness. On the 231st day, EEG showed spike-and-waves on the left and right frontal areas. Interestingly, paroxysmal activities preceded the onset of epileptic seizures by 7 months, and spike-and-waves by 2 months. After 10 months, he had generalized seizures with fever, and partial seizures on awakening without fever. Interictal EEG showed spike-and-waves on the bilateral frontal areas, and diffuse polyspikes and slow waves were occasionally seen. Though the background activity improved, his consciousness level did not recover probably because the thalamus, basal ganglia, brainstem were damaged more severely than the cerebral cortex.
我们在此报告一例与甲型流感病毒感染相关的儿童急性坏死性脑病后出现症状性部分性癫痫的病例。这个2岁男孩接受了多次脑电图记录,急性期以弥漫性1-2Hz慢波为主。病程第49天时背景活动为5Hzθ波。发病第89天后出现阵发性活动。在第231天时,脑电图显示左右额叶区有棘波和慢波。有趣的是,阵发性活动比癫痫发作提前7个月出现,棘波和慢波比癫痫发作提前2个月出现。10个月后,他出现发热性全身性发作,以及无发热的觉醒时部分性发作。发作间期脑电图显示双侧额叶区有棘波和慢波,偶尔可见弥漫性多棘波和慢波。尽管背景活动有所改善,但他的意识水平并未恢复,可能是因为丘脑、基底神经节、脑干比大脑皮层受损更严重。