Kayaalp Levent, Dervent Aysin, Saltik Sema, Uluduz Derya, Kayaalp Inci Vural, Demirbilek Veysi, Ghaziuddin Mohammad
Istanbul University, Cerrahpasa Medical Faculty, Child Psychiatry Department, Istanbul, Turkey.
Brain Dev. 2007 Jul;29(6):336-45. doi: 10.1016/j.braindev.2006.10.002. Epub 2006 Nov 17.
Autism may develop in children with West syndrome. This study was conducted to determine if EEG abnormalities in patients with West syndrome predict the later onset of autism. Two groups of patients with West syndrome, older than 6 years of age, were studied. One group consisted of those with a past history of West syndrome plus autism (N=14); the control group consisted of those with a past history of West syndrome but without autism (N=14). Patients were followed at regular intervals and video-EEG recordings were done. A total of 108 (autistic group) and 123 (non-autistic group) video-EEGs were examined. The two groups were compared with respect to age, presence or absence of hypsarrhythmia, and characteristics and localization of the epileptogenic foci. chi2 and Fisher's exact tests were used. The number of patients with at least one hypsarrhythmic EEG at the age of one year or later was significantly higher in autistic subjects (86%) than in non-autistic controls (29%). The incidence of EEGs with hypsarrhythmia was also higher in the autistic group, especially in older children (autistic, 49% versus non-autistic, 18% at age 3 years and later). Frontal predominance of the primary foci on EEGs with or without hypsarrhythmia was seen in 95.3% of the autistic group and 28.8% of the non-autistic group (p=0.001). Frontal abnormalities on the EEGs, which were mainly bilateral, and the persistence of hypsarrhythmia were significantly related to the emergence of autistic behavior in patients with West syndrome. These findings suggest that paroxysmal discharges in the cortical areas undergoing rapid maturation may be involved in the development of autistic features.
自闭症可能在患有韦斯特综合征的儿童中出现。本研究旨在确定韦斯特综合征患者的脑电图异常是否能预测自闭症的后期发病。对两组年龄大于6岁的韦斯特综合征患者进行了研究。一组由有韦斯特综合征病史且伴有自闭症的患者组成（N = 14）；对照组由有韦斯特综合征病史但无自闭症的患者组成（N = 14）。定期对患者进行随访并进行视频脑电图记录。共检查了108份（自闭症组）和123份（非自闭症组）视频脑电图。比较了两组在年龄、是否存在高峰失律以及致痫灶的特征和定位方面的情况。使用了卡方检验和费舍尔精确检验。自闭症患者中在1岁及以后至少有一次高峰失律脑电图的患者数量（86%）显著高于非自闭症对照组（29%）。自闭症组中伴有高峰失律的脑电图发生率也更高，尤其是在年龄较大的儿童中（自闭症组在3岁及以后为49%，非自闭症组为18%）。在伴有或不伴有高峰失律的脑电图上，原发性病灶以额叶为主在自闭症组中占95.3%，在非自闭症组中占28.8%（p = 0.001）。脑电图上的额叶异常（主要为双侧性）以及高峰失律的持续存在与韦斯特综合征患者自闭症行为的出现显著相关。这些发现表明，快速成熟的皮质区域的阵发性放电可能与自闭症特征的发展有关。
