Aneja S, Ahuja B, Taluja V, Bhatia V K
Department of Pediatrics and Physical Medicine and Rehabilitation, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital and Indian Agricultural Statistics Research Institute, New Delhi, India.
Indian J Pediatr. 2001 Feb;68(2):111-5. doi: 10.1007/BF02722024.
This article deals with the clinical profile of children with cerebral palsy and epilepsy, and to study the clinical predictors of response to anti-epileptic drugs. It is a prospective hospital based follow-up study. All the children who presented with cerebral palsy and history of seizure (other than neonatal seizures) over a period of one year were included. Seizures were classified according to ILAE classification. An EEG was obtained in all cases. Neuroimaging was done in all patients. Eighty-five patients were studied and followed for minimum of 12 months. Perinatal factors accounted for 62 (72.3%) cases. The motor deficits seen were quadriparesis (n = 64), hemiplegia (n = 12) and diplegia (n = 9). Associated mental retardation was seen in 80.9% patients with quadriparesis. A predominance of generalised epilepsy was seen with generalised tonic clonic seizures (32.9%) followed by mycolonic seizures (30.6%) and localisation related epilepsy (24.7%). The patients with quadriparesis were more likely to have generalised epilepsy and 52.4% of them required two or more anti-epileptic drugs for control of seizures. Patients with hemiplegia had localisation related epilepsy in 83.3% of cases. On multivariate analysis presence of quadriparesis, microcephaly, mental retardation and myoclonic epilepsy were found to predict the poor response to AED. Epilepsy in patients with cerebral palsy is of severe nature and difficult to control. Presence of quadriparesis, mental retardation and myoclonic seizures was predictive of poor response to anti- epileptic drugs.
本文探讨脑瘫合并癫痫患儿的临床特征，并研究抗癫痫药物反应的临床预测因素。这是一项基于医院的前瞻性随访研究。纳入了在一年时间内出现脑瘫且有癫痫发作史（新生儿癫痫除外）的所有儿童。癫痫发作根据国际抗癫痫联盟（ILAE）分类进行分类。所有病例均进行了脑电图检查。所有患者均进行了神经影像学检查。对85例患者进行了研究，并至少随访12个月。围产期因素占62例（72.3%）。观察到的运动障碍包括四肢瘫（n = 64）、偏瘫（n = 12）和双瘫（n = 9）。80.9%的四肢瘫患者伴有智力发育迟缓。全身性癫痫以全身强直阵挛发作为主（32.9%），其次是肌阵挛发作（30.6%）和局灶性相关性癫痫（24.7%）。四肢瘫患者更易发生全身性癫痫，其中52.4%的患者需要两种或更多抗癫痫药物来控制癫痫发作。偏瘫患者中83.3%的病例为局灶性相关性癫痫。多因素分析发现，四肢瘫、小头畸形、智力发育迟缓及肌阵挛性癫痫的存在可预测对抗癫痫药物反应不佳。脑瘫患者的癫痫病情严重且难以控制。四肢瘫、智力发育迟缓及肌阵挛发作的存在可预测对抗癫痫药物反应不佳。
