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脑瘫儿童癫痫的危险因素。

Risk factors for epilepsy in children with cerebral palsy.

机构信息

Department of Pediatrics and the Child Development Center, Carmel Medical Center, Rappaport Faculty of Medicine, 7 Michal Street, 34383 Technion, Haifa, Israel.

出版信息

Eur J Paediatr Neurol. 2010 Jan;14(1):67-72. doi: 10.1016/j.ejpn.2009.06.002. Epub 2009 Jul 2.

Abstract

The purpose of the study was to identify predictive risk factors for epilepsy among children with cerebral palsy. We conducted a retrospective study of the clinical characteristics of children with cerebral palsy and epilepsy in comparison to those of children with cerebral palsy without epilepsy. The examined parameters included: the prevalence and the age of onset of the seizures, the clinical subgroup of cerebral palsy and subtype of epileptic seizures. We looked for possible risk factors including the presence of neonatal seizures, the imaging findings, the gestational age at delivery, the adjusted birth weight, the mode of delivery, the Apgar scores, and the head size as well as the presence of consanguinity. Epilepsy occurred in 33% of the studied children. Almost 50% of the epileptic children had their first seizure within the first 12 months of life. Neonatal seizures were strong predictors for epilepsy (p<0.001). Presence of at least one abnormal structural finding (particularly brain atrophy) was also a significant predictor of epilepsy (p<0.003). Low Apgar score at 5 min after birth and birth at term were also found more frequently among patients with epilepsy, although when adjusted with other risk factors, Apgar score did not reach statistical significance. The mode of delivery, head circumference, adjusted birth weight, gender and ethnic group, consanguineous marriage and prematurity were not found to be risk factors for the occurrence of epilepsy in these children.

摘要

本研究旨在确定脑瘫儿童癫痫的预测风险因素。我们对脑瘫伴癫痫儿童与脑瘫无癫痫儿童的临床特征进行了回顾性比较研究。检查的参数包括:癫痫发作的患病率和发病年龄、脑瘫的临床亚组和癫痫发作的亚型。我们寻找了可能的风险因素,包括新生儿癫痫发作、影像学发现、分娩时的胎龄、校正出生体重、分娩方式、阿普加评分以及头围和近亲结婚的存在。癫痫发生在 33%的研究儿童中。近 50%的癫痫患儿在生命的头 12 个月内首次发作。新生儿癫痫发作是癫痫的强烈预测因素(p<0.001)。至少存在一种异常结构发现(特别是脑萎缩)也是癫痫的显著预测因素(p<0.003)。尽管在调整其他危险因素后,出生后 5 分钟的阿普加评分较低和足月分娩也更常见于癫痫患者,但阿普加评分并未达到统计学意义。分娩方式、头围、校正出生体重、性别和种族、近亲结婚和早产均未被发现是这些儿童癫痫发作的危险因素。

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