Selton D, André M, Hascoët J M
Service de néonatologie, maternité régionale, 10, rue du Docteur-Heydenreich, 54042 Nancy, France.
Neurophysiol Clin. 2003 Jun;33(3):120-9. doi: 10.1016/s0987-7053(03)00030-3.
The aims of this study were to describe EEG anomalies in unilateral neonatal ischemic stroke without hypoxic-ischemic encephalopathy, and to determine possible links between these abnormalities and long-term outcome. In 6 full-term newborns without severe fetal distress ischemic stroke was confirmed by computed tomography and/or magnetic resonance imaging. Twenty EEGs were recorded during the neonatal period, 5 in acute stage and 15 later. The duration of the follow-up ranged from 3 to 9 years. All newborns developed unilateral clonic seizures, right-sided (5 cases) or left-sided (1 case); seizures began between 14 and 48 h of life. At follow-up, 3 children were normal at 2 and 6 years of age, while the 3 others had sequelae: epilepsy at 9 years of age in one, and unilateral mild cerebral palsy in the 2 others (3 and 4 years of age), with behavioral problems in one of them. Critical EEG discharges, rhythmic sharp waves and/or slow waves were recorded on the injured side. Abnormalities of interictal activity were excess of alpha or theta rhythms, transitory EEG discontinuity or low voltage. The 2 children with cerebral palsy had numerous unilateral post-ictal positive rolandic slow sharp waves (PRSSWs), which were similar to the positive rolandic sharp waves of premature infants; the child with behavioral problems had numerous positive left-sided temporal fast sharp waves. PRSSWs could be associated with contralateral motor sequelae, while positive left temporal fast sharp waves were associated with long term behavioral problems. These findings may be used for future prospective studies aimed at specifying the relation between EEG abnormalities and long-term outcome.
本研究的目的是描述无缺氧缺血性脑病的单侧新生儿缺血性卒中的脑电图异常情况,并确定这些异常与长期预后之间的可能联系。在6名无严重胎儿窘迫的足月儿中,通过计算机断层扫描和/或磁共振成像确诊为缺血性卒中。在新生儿期记录了20份脑电图,其中5份在急性期,15份在之后。随访时间为3至9年。所有新生儿均出现单侧阵挛性惊厥,右侧(5例)或左侧(1例);惊厥在出生后14至48小时开始。随访时,3名儿童在2岁和6岁时正常,而另外3名有后遗症:1名在9岁时患癫痫,另外2名(3岁和4岁)患单侧轻度脑瘫,其中1名有行为问题。在损伤侧记录到临界脑电图放电、节律性尖波和/或慢波。发作间期活动异常表现为α或θ节律过多、短暂性脑电图间断或低电压。2名脑瘫患儿有大量单侧发作后阳性罗兰区慢尖波(PRSSWs),类似于早产儿的阳性罗兰区尖波;有行为问题的患儿有大量左侧颞部阳性快尖波。PRSSWs可能与对侧运动后遗症有关,而左侧颞部阳性快尖波与长期行为问题有关。这些发现可用于未来旨在明确脑电图异常与长期预后之间关系的前瞻性研究。