Cooper G W, Lee S I
Department of Neurology, University of Virginia Health Sciences Center, Charlottesville 22908.
Epilepsia. 1991 Jan-Feb;32(1):63-8. doi: 10.1111/j.1528-1157.1991.tb05613.x.
Occipital epileptiform activity that is almost continuous and reactive to eye opening has been associated with a childhood epilepsy syndrome and basilar migraine with seizures. An association of these syndromes with a benign course had been disputed. In this study, a retrospective investigation of reactive occipital epileptiform activity (ROEA) was performed to determine the prognostic value of this distinctive EGG pattern. The EEG and hospital record of patients with ROEA were reviewed with an observation period of 6 months to 8 years. The patients were divided into good and poor outcome groups based on response to treatment. Of 33 patients, 12 (36.4%) had complete seizure control; 21 (63.6%) continued to have poorly controlled seizures. Only 3 (9.1%) patients were able to discontinue antiepileptic drugs (AEDs) without seizure recurrence. Analysis of clinical and EEG variables showed that a history of perinatal difficulties, abnormal neurologic findings, and abnormal EEG background activities occur significantly more frequently in the poor outcome group. This study suggests that ROEA is not uniformly associated with a benign course and that other factors are involved in determining prognosis of the epilepsy.
几乎持续存在且对睁眼有反应的枕叶癫痫样活动与一种儿童癫痫综合征以及伴有癫痫发作的基底型偏头痛有关。这些综合征与良性病程之间的关联一直存在争议。在本研究中，对反应性枕叶癫痫样活动（ROEA）进行了回顾性调查，以确定这种独特脑电图模式的预后价值。对ROEA患者的脑电图和医院记录进行了回顾，观察期为6个月至8年。根据治疗反应将患者分为预后良好组和预后不良组。33例患者中，12例（36.4%）癫痫发作得到完全控制；21例（63.6%）癫痫发作仍控制不佳。只有3例（9.1%）患者能够停用抗癫痫药物（AEDs）且无癫痫复发。临床和脑电图变量分析表明，围产期困难史、神经系统检查异常以及脑电图背景活动异常在预后不良组中出现的频率显著更高。本研究表明，ROEA并非始终与良性病程相关，其他因素也参与了癫痫预后的判定。
