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[2006 - 2007年住院的3至18岁儿童症状性癫痫的病因]

[The causes of symptomatic epilepsy in children aged 3-18 years hospitalized in the year 2006-2007].

作者信息

Gergont Aleksandra, Kroczka Sławomir, Kaciński Marek

机构信息

Klinika Neurologii Dzieciecej, Uniwersytet Jagielloński Collegium Medicum, Kraków.

出版信息

Przegl Lek. 2008;65(11):751-7.

Abstract

BACKGROUND

Epilepsy can be one of symptoms of the damage to CNS in children with neurodevelopmental deficits, it is more difficult however to diagnose seizures if they are the first symptom of severe brain damage.

THE AIM

This retrospective research was conducted to study causes of symptomatic epilepsy in children aged 3-18 year hospitalized between 2006 and 2007 year in the Department of Pediatric Neurology.

MATERIAL AND METHODS

156 children with symptomatic epilepsy occurred after 2 years of life were included. The diagnosis of symptomatic epilepsy was established including clinical picture, neuro-radiological tests and EEG. The information from parents was helpful to analyze the type of seizures. The clinical state of children was analyzed, especially psychomotor development, focal deficits, as well as results of CT and/or MRI, in some children psychological testing was performed, molecular or serological.

RESULTS

156 children with epilepsy were hospitalized, within encephalopathy was diagnosed in 61 children. In 42 children static encephalopathy was associated with birth trauma, in 7 progressive encephalopathy was diagnosed, in 1 child CO intoxication caused encephalopathy, and in 11 cases the cause was not identified. Malformations of nervous system were associated with epilepsy in 37 children, geneticaly determined syndromes in 6, and the head trauma in other 6 children. Disorders of vascular origin caused epilepsy in 16 children, and neuroinfections in 9 children. In 2 children epilepsy was associated with ADEM, and in 11 children nonspecific de/dysmyelination was detected. The brain tumor was detected in 6 children with symptomatic epilepsy.

CONCLUSIONS

The most common disorder leading to epilepsy in children aged 3-18 years was encephalopathy, within hypoxic-ischemic encephalopathy. The other in sequence were malformations of nervous system and vascular diseases.

摘要

背景

癫痫可能是神经发育缺陷儿童中枢神经系统损伤的症状之一,然而,如果癫痫是严重脑损伤的首发症状,则更难诊断。

目的

本回顾性研究旨在探讨2006年至2007年在儿科神经科住院的3至18岁儿童症状性癫痫的病因。

材料与方法

纳入156例2岁以后发生症状性癫痫的儿童。通过临床表现、神经放射学检查和脑电图建立症状性癫痫的诊断。来自家长的信息有助于分析癫痫发作类型。分析了儿童的临床状况,特别是精神运动发育、局灶性缺陷,以及CT和/或MRI结果,部分儿童进行了分子或血清学心理测试。

结果

156例癫痫患儿住院,其中61例诊断为脑病。42例静态脑病与出生创伤有关,7例诊断为进行性脑病,1例一氧化碳中毒导致脑病,11例病因不明。37例儿童神经系统畸形与癫痫有关,6例为基因决定综合征,另6例为头部外伤。血管源性疾病导致16例儿童癫痫,9例为神经感染。2例儿童癫痫与急性播散性脑脊髓炎有关,11例检测到非特异性脱髓鞘/髓鞘发育异常。6例症状性癫痫患儿检测到脑肿瘤。

结论

3至18岁儿童癫痫最常见的病因是脑病,其中以缺氧缺血性脑病为主。其次依次为神经系统畸形和血管疾病。

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