Primec Zvonka Rener, Stare Janez, Neubauer David
Department of Child Neurology, University Children's Hospital, University of Ljubljana, Ljubljana, Slovenia.
Epilepsia. 2006 Dec;47(12):2202-5. doi: 10.1111/j.1528-1167.2006.00888.x.
To assess the correlation between hypsarrhythmia duration and mental outcome in infantile spasms (IS) the medical records of 48 infants with IS were reviewed retrospectively and psychological assessments undertaken at follow-up at the age of 3 to 13 years. We found 18 (38%) cryptogenic IS cases with typical hypsarrhythmia and 30 symptomatic with modified hypsarrhythmia-further classified into 15 cases as multifocal, 10 as pseudoperiodic and 5 as unilateral hypsarrhythmia. A short treatment lag (one to two weeks) occurred in 25, three to four weeks in 10 cases. Spasms ceased within one month after treatment in 23 infants. At follow-up 15 children had normal mental outcome (borderline included). A correlation between hypsarrhythmia duration longer than three weeks and lower mental outcome was found using the logistic regression model. The duration of hypsarrhythmia represents a sensitive prognostic parameter in IS; the risk of mental retardation increases after three weeks of hypsarrhythmia.
为评估婴儿痉挛症（IS）中高峰失律持续时间与智力预后之间的相关性，我们回顾性分析了48例IS患儿的病历，并在其3至13岁随访时进行了心理评估。我们发现18例（38%）隐源性IS病例有典型高峰失律，30例症状性IS有变异型高峰失律——进一步分为15例多灶性、10例假周期性和5例单侧高峰失律。25例治疗延迟较短（1至2周），10例为3至4周。23例婴儿在治疗后1个月内痉挛停止。随访时，15名儿童智力预后正常（包括临界正常）。使用逻辑回归模型发现，高峰失律持续时间超过3周与较低的智力预后之间存在相关性。高峰失律持续时间是IS中一个敏感的预后参数；高峰失律3周后智力发育迟缓的风险增加。
