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脑裂畸形:临床与神经影像学特征之间的相关性

Schizencephaly: correlation between clinical and neuroimaging features.

作者信息

Liang Jao-Shwann, Lee Wang-Tso, Peng Steven Shinn-Forng, Yu Tsai-Wen, Shen Yu-Zen

机构信息

Department of Pediatrics, National Taiwan University Hospital, Taipei.

出版信息

Acta Paediatr Taiwan. 2002 Jul-Aug;43(4):208-13.

Abstract

Schizencephaly is an uncommon congenital brain malformation. We report our experience of 13 patients with schizencephaly and evaluate the clinical, neuroradiologic, electroencephalographic (EEG), and nosological features. Of these 13 patients, 8 were unilateral forms, 5 were bilateral forrms and 11 were open-lip type schizencephaly. One patient was proven to have cytomegalovirus (CMV) infection. The clinicalfeatures and neurodevelopmental outcomes are variable. Although seizure developed in 9 patients (5 patients from unilateral and 4 from bilateral forms), the severity of epilepsy was not totally related to the degree of malformations. The neurodevelopmental outcome depended on the extent of schizencephaly as well as the seizure control. Those with bilateral forms and intractable seizures had the worst outcome. Other central nervous system (CNS) anomalies were observed in 11 patients. Six out of 11 patients had focal cortical dysplasia. We conclude that children with schizencephaly usually have variable neurological impairment. Earlier diagnosis of schizencephaly and related CNS malformation with neuroimaging is helpful in predicting the neurodevelopmental outcomes in these patients.

摘要

脑裂畸形是一种罕见的先天性脑畸形。我们报告了13例脑裂畸形患者的情况,并评估了其临床、神经放射学、脑电图(EEG)及疾病分类学特征。这13例患者中,8例为单侧型,5例为双侧型,11例为开放性唇裂型脑裂畸形。1例患者被证实有巨细胞病毒(CMV)感染。临床特征和神经发育结局各不相同。虽然9例患者(单侧型5例,双侧型4例)出现了癫痫发作,但癫痫的严重程度与畸形程度并不完全相关。神经发育结局取决于脑裂畸形的范围以及癫痫控制情况。双侧型且癫痫难以控制的患者结局最差。11例患者还观察到其他中枢神经系统(CNS)异常。11例患者中有6例患有局灶性皮质发育异常。我们得出结论,脑裂畸形患儿通常有不同程度的神经功能损害。通过神经影像学早期诊断脑裂畸形及相关的中枢神经系统畸形,有助于预测这些患者的神经发育结局。

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