Trevathan Edwin
Pediatric Epilepsy Center, St. Louis Children's Hospital, MO 63110-1093, USA.
J Child Neurol. 2002 Feb;17 Suppl 2:2S9-2S22. doi: 10.1177/08830738020170021201.
Infantile spasms and Lennox-Gastaut syndrome are rare but are important to child neurologists because of the intractable nature of the seizures and the serious neurologic comorbidities. New antiepileptic drugs offer more alternatives for treating both infantile spasms and Lennox-Gastaut syndrome. Selected children with infantile spasms are candidates for epilepsy surgery. Vagus nerve stimulation, corpus callosotomy, and the ketogenic diet are all options for selected children with Lennox-Gastaut syndrome. The epidemiology, clinical manifestations of the seizures, electroencephalographic characteristics, prognosis, and treatment options are reviewed for infantile spasms and Lennox-Gastaut syndrome. Additional therapies are needed for both infantile spasms and Lennox-Gastaut syndrome as many children fail to achieve adequate seizure control in spite of newer treatments.
婴儿痉挛症和Lennox-Gastaut综合征较为罕见,但因其癫痫发作的顽固性和严重的神经共病,对儿童神经科医生而言很重要。新型抗癫痫药物为治疗婴儿痉挛症和Lennox-Gastaut综合征提供了更多选择。部分患有婴儿痉挛症的儿童适合进行癫痫手术。迷走神经刺激、胼胝体切开术和生酮饮食都是部分Lennox-Gastaut综合征患儿的治疗选择。本文对婴儿痉挛症和Lennox-Gastaut综合征的流行病学、癫痫发作的临床表现、脑电图特征、预后及治疗选择进行了综述。尽管有了新的治疗方法,但仍有许多儿童未能实现充分的癫痫控制,因此婴儿痉挛症和Lennox-Gastaut综合征都需要额外的治疗。