Komatsu Mitsutaka, Okumura Akihisa, Matsui Kotoko, Kitamura Tomohiro, Sato Toshihiko, Shimizu Toshiaki, Watanabe Kazuyoshi
Department of Pediatrics, Urayasu Ichikawa Municipal Hospital, Urayasu, Japan.
Brain Dev. 2010 Jun;32(6):472-6. doi: 10.1016/j.braindev.2009.09.012. Epub 2009 Oct 12.
Using single-channel amplitude-integrated electroencephalography (aEEG), we monitored clustered seizures in a 12-month-old boy suffering from acute encephalopathy with biphasic seizures and late reduced diffusion (AESD). He was admitted to our hospital after losing consciousness and experiencing repeated seizures in association with fever. Although the patient's state of consciousness improved the next day, it declined on the fifth day of illness, and clinical seizures were observed. Diffusion-weighted images revealed abnormal high intensities in the frontal area bilaterally. On the same day, aEEG monitoring revealed an unexpected cluster of subclinical seizures. Attending pediatricians, nurses, and other caregivers did not recognize the presence of these frequent subclinical seizures. The efficacy of antiepileptic drugs could also be objectively assessed from aEEG findings. aEEG is useful for continuous monitoring in children with acute encephalopathy, may disclose subclinical seizures, and can contribute to an objective evaluation of the efficacy of antiepileptic drugs.
我们使用单通道振幅整合脑电图(aEEG)对一名12个月大的患有伴有双相性癫痫发作和晚期弥散受限的急性脑病(AESD)的男孩的丛集性癫痫发作进行了监测。他在意识丧失并伴有发热反复癫痫发作后被收治入院。尽管患者的意识状态在第二天有所改善,但在患病第五天又恶化了,且观察到临床癫痫发作。弥散加权成像显示双侧额叶区域有异常高强度信号。同一天,aEEG监测发现了意外的亚临床癫痫发作丛集。主治儿科医生、护士及其他护理人员均未识别出这些频繁的亚临床癫痫发作的存在。抗癫痫药物的疗效也可根据aEEG结果进行客观评估。aEEG对于急性脑病患儿的持续监测很有用,可能会揭示亚临床癫痫发作,并有助于对抗癫痫药物疗效进行客观评估。