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婴儿期反射性肌阵挛癫痫:一种新的反射性癫痫综合征还是婴儿良性肌阵挛癫痫的一种变异型?

[Reflex myoclonic epilepsy in infancy: a new reflex epilepsy syndrome or a variant of benign myoclonic epilepsy in infancy].

作者信息

Caraballo R, Cassar L, Monges S, Yepez I, Galicchio S, Cersósimo R, Fejerman N

机构信息

Servicio de Neurología, Hospital Nacional de Pediatría Juan P. Garrahan, Buenos Aires, Argentina.

出版信息

Rev Neurol. 2003;36(5):429-32.

Abstract

CASE REPORTS

We report a clinical and EEG study of 8 children with reflex myoclonic epilepsy of infancy to further confirm the existence of this syndrome first described by Ricci et al in 1995.

RESULTS

Between February 1990 to July 2002, we identified 64 epileptic patients with myoclonic seizures with an onset in the first six years of life. Eight (12.5%) of these patients had myoclonic seizure stimuli sensible. The seizures were characterized by generalized, myoclonic jerks triggered by tactile stimuli in six patients and acoustic stimuli in two, in one of them myoclonic jerks were triggered by both types of stimuli. The seizures appeared between 5 and 20 months of age. Two of the 8 patients had spontaneous myoclonic attacks during sleep. Interictal EEG was normal during wakefulness and occasional discharges were evident during sleep. In contrast, the ictal EEG during both wakefulness and sleep showed generalized spike wave and polyspike slow wave paroxysms. Neurologic examination, neuroimaging and neurometabolic studies were normal. Myoclonic jerks disappeared in 6 patients after valproic acid administration and in two after clobazan administration. Antiepileptic treatment was discontinued in 6 patients and no seizure recurrence was observed during a median follow up of 6 years.

CONCLUSION

Our patients presented electro clinical criteria compatible with the syndrome of reflex myoclonic epilepsy of infancy. This syndrome could be considered to be a new reflex epileptic syndrome or a variant of benign myoclonic epilepsy in infancy.

摘要

病例报告

我们报告了一项对8例婴儿反射性肌阵挛癫痫患儿的临床和脑电图研究,以进一步证实1995年由里奇等人首次描述的该综合征的存在。

结果

在1990年2月至2002年7月期间,我们确定了64例在出生后前六年发病的肌阵挛发作癫痫患者。其中8例(12.5%)患者的肌阵挛发作对刺激敏感。发作特点为6例患者由触觉刺激引发全身性肌阵挛抽搐,2例由听觉刺激引发,其中1例两种刺激均可引发肌阵挛抽搐。发作出现在5至20个月龄之间。8例患者中有2例在睡眠期间出现自发性肌阵挛发作。发作间期脑电图在清醒时正常,睡眠期间偶有放电。相比之下,清醒和睡眠期间的发作期脑电图均显示全身性棘波和多棘慢波阵发。神经学检查、神经影像学和神经代谢研究均正常。6例患者在服用丙戊酸后肌阵挛抽搐消失,2例在服用氯巴占后消失。6例患者停用抗癫痫药物,在中位随访6年期间未观察到癫痫复发。

结论

我们的患者呈现出符合婴儿反射性肌阵挛癫痫综合征的电临床标准。该综合征可被视为一种新的反射性癫痫综合征或婴儿良性肌阵挛癫痫的一种变体。

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