Masri Amira, Badran Eman, Hamamy Hanan, Assaf Abeer, Al-Qudah Abdelkarim A
The University of Jordan, Faculty of Medicine, Pediatric Department, Division of Child Neurology, Jordan.
Clin Neurol Neurosurg. 2008 Apr;110(4):352-6. doi: 10.1016/j.clineuro.2007.12.013. Epub 2008 Feb 4.
To determine the etiologies, outcomes, and risk factors for epilepsy in infants.
This retrospective study included all children who had their first afebrile seizure between 1 and 12 months of age, and who were followed in the Child Neurology Clinic at the Jordan University Hospital from January 2004 to January 2006. Medical records were reviewed to collect demographic data and the clinical data pertaining to epilepsy. An age-matched control group of healthy children in a 1:2 ratio was included to determine the risk factors for epilepsy. For statistical analysis, SPSS, Version 13, was used.
Fifty-five patients were included in the study group and 111 were in the control group. Epilepsy was classified as follows: symptomatic in 24 (43.6%) children, probably symptomatic (cryptogenic) in 28 (50.9%) children, and idiopathic in 3 (5.5%) children. The etiologies of epilepsy in the symptomatic group included hypoxic-ischemic encephalopathy (n=11), cortical malformations (n=5), neurocutaneous syndromes (n=2), metabolic disorders (n=4), leukodystrophy (n=1), and craniosynostosis (n=1). Twenty-seven patients (49%) were seizure-free at their last follow-up visit for at least the last 6 months; only six patients (10.9%) continued to have normal development at the time of their last follow-up examination. The risk factors for epilepsy included parental consanguinity (P=0.0003), a family history of global developmental delay (P=0.0002), a family history of epilepsy (P=0.010), and a positive perinatal history (P=0.011).
This study emphasized that afebrile convulsions in infancy are rarely benign. Furthermore, consanguinity was shown to be a major risk factor for epilepsy.
确定婴儿癫痫的病因、结局及危险因素。
这项回顾性研究纳入了所有在1至12个月大时首次出现无热惊厥，且于2004年1月至2006年1月在约旦大学医院儿童神经科门诊接受随访的儿童。查阅医疗记录以收集人口统计学数据及与癫痫相关的临床资料。纳入一个年龄匹配的健康儿童对照组，比例为1:2，以确定癫痫的危险因素。采用SPSS 13版进行统计分析。
研究组纳入55例患者，对照组纳入111例。癫痫分类如下：症状性癫痫24例（43.6%），可能症状性（隐源性）癫痫28例（50.9%），特发性癫痫3例（5.5%）。症状性癫痫组的病因包括缺氧缺血性脑病（n = 11）、皮质发育畸形（n = 5）、神经皮肤综合征（n = 2）、代谢紊乱（n = 4）、脑白质营养不良（n = 1）和颅缝早闭（n = 1）。27例患者（49%）在最后一次随访时至少在过去6个月内无癫痫发作；仅6例患者（10.9%）在最后一次随访检查时仍发育正常。癫痫的危险因素包括父母近亲结婚（P = 0.0003）、全球发育迟缓家族史（P = 0.0002）、癫痫家族史（P = 0.010）和围产期阳性病史（P = 0.011）。
本研究强调婴儿期无热惊厥很少是良性的。此外，近亲结婚被证明是癫痫的主要危险因素。
