Trinka Eugen, Unterrainer J, Haberlandt E, Luef G, Unterberger I, Niedermüller U, Haffner B, Bauer G
Universitätsklinik für Neurologie, Innsbruck, Anichstrasse 35, Austria.
Epilepsy Res. 2002 Aug;50(3):283-92. doi: 10.1016/s0920-1211(02)00083-9.
To analyze the spectrum of epilepsy syndromes which follow childhood febrile convulsions (FC) and to examine whether retrospective analysis of clinical features of the FC enables discrimination of patients who develop temporal lobe epilepsy (TLE) from those who develop generalized epilepsy (GE). One hundred and thirteen patients with epilepsy and antecedent FC were retrospectively analyzed. We inquired in detail about the clinical characteristics of FC (age, duration, number, focal symptoms) as well as family history, birth history, neurological status, and psychomotor development before onset of FC. Forty five (39.8%) patients had TLE, 41 (36.6%) GE, and 27 (23.9%) had extratemporal epilepsy (ETE). Patients with TLE had a significantly longer duration of FC (P< or =0.001), more often focal features (P< or =0.001), and febrile status epilepticus (P< or =0.001) than patients with GE. Age at FC, Number of FC, family history, birth history and neurological status at FC did not differ between groups. A stepwise discriminant model allowed correct assignment after cross validation in 84.2% to TLE and in 100% to GE. A broad spectrum of epilepsy syndromes follow FC. We found a strong association of prolonged and focal FC with later development of TLE. Short generalized FC were associated with GE.
分析儿童热性惊厥（FC）后癫痫综合征的谱型，并检查对FC临床特征的回顾性分析是否能够区分发生颞叶癫痫（TLE）的患者和发生全身性癫痫（GE）的患者。对113例有癫痫病史且既往有FC的患者进行回顾性分析。我们详细询问了FC的临床特征（年龄、持续时间、发作次数、局灶性症状）以及FC发作前的家族史、出生史、神经状态和精神运动发育情况。45例（39.8%）患者患有TLE，41例（36.6%）患有GE，27例（23.9%）患有颞叶外癫痫（ETE）。与GE患者相比，TLE患者的FC持续时间显著更长（P≤0.001），局灶性特征更常见（P≤0.001），热性惊厥持续状态更常见（P≤0.001）。FC发作时的年龄、FC发作次数、家族史、出生史和神经状态在各组之间没有差异。逐步判别模型在交叉验证后对TLE的正确分类率为84.2%，对GE的正确分类率为100%。FC后有广泛的癫痫综合征谱型。我们发现延长和局灶性FC与TLE的后期发生密切相关。短暂全身性FC与GE相关。
