Sadleir L G, Farrell K, Smith S, Connolly M B, Scheffer I E
Department of Paediatrics, Wellington School of Medicine and Health Sciences, University of Otago, Wellington, South New Zealand.
Neurology. 2006 Aug 8;67(3):413-8. doi: 10.1212/01.wnl.0000228257.60184.82.
To accurately define the electroclinical features of absence seizures in children with newly diagnosed, untreated childhood absence epilepsy (CAE).
The authors searched an EEG database for absence seizures in normal children with new onset untreated absence epilepsy. Seventy consecutive children were classified into IGE syndromes. The clinical and EEG features of the seizures in the children with CAE were analyzed using video-EEG recordings.
The authors analyzed 339 absence seizures in 47 children with CAE. The average seizure duration was 9.4 seconds and clinical features consisted of arrest of activity, loss of awareness, staring, and 3-Hz eyelid movements, but there was individual variation. Ictal EEG predominantly showed regular 3-Hz generalized spike and wave (GSW) with one or two spikes per wave; however, disorganization of discharges was common and three or more spikes per wave occurred rarely. Postictal slowing was frequent. Interictal abnormalities included fragments of GSW, posterior bilateral delta activity, and focal discharges. Although all 47 children met the current criteria for CAE, only 5 fulfilled the recently proposed criteria for CAE.
The heterogeneous nature of each clinical and EEG feature of untreated absence seizures is of critical importance when determining criteria for childhood absence epilepsy.
准确界定新诊断、未经治疗的儿童失神癫痫（CAE）患儿失神发作的电临床特征。
作者在一个脑电图数据库中搜索新发作、未经治疗的失神癫痫正常儿童的失神发作情况。连续70名儿童被归类为特发性全身性癫痫（IGE）综合征。使用视频脑电图记录分析CAE患儿发作的临床和脑电图特征。
作者分析了47例CAE患儿的339次失神发作。平均发作持续时间为9.4秒，临床特征包括活动停止、意识丧失、凝视和3赫兹眼睑运动，但存在个体差异。发作期脑电图主要表现为规则的3赫兹广泛性棘慢波（GSW），每波有一或两个棘波；然而，放电紊乱很常见，每波三个或更多棘波很少出现。发作后期慢波常见。发作间期异常包括GSW片段、双侧后头部δ活动和局灶性放电。虽然所有47名儿童均符合当前CAE标准，但只有5名符合最近提出的CAE标准。
在确定儿童失神癫痫的标准时，未经治疗的失神发作的每个临床和脑电图特征的异质性至关重要。
