Epilepsy Center/Neurological Institute, Cleveland Clinic, 9500 Euclid Ave, S-91, Cleveland, OH 44195, USA.
Pediatr Neurol. 2009 Dec;41(6):428-34. doi: 10.1016/j.pediatrneurol.2009.07.004.
Few reports are available of ictal recordings in patients with benign focal epileptiform discharges. The study objective was to estimate the frequency of such recordings and to describe their clinical and electrophysiologic presentation. We performed a retrospective chart review of all patients undergoing routine electroencephalography (EEG) with video during a 10-year period. Among 214 patients with benign focal epileptiform discharges, 5 patients were identified with recorded EEG seizures (2.3%). Epilepsy syndromes included one case of benign focal epilepsy of childhood, three cases of childhood absence epilepsy, and in one case the patient presented with both. Only 1 of the 214 patients (0.4%) had a seizure characteristic of benign focal epilepsy of childhood. A literature review revealed the coexistence of childhood absence and benign focal epilepsy of childhood or benign focal epileptiform discharges within the same patient. These findings suggest that benign focal epilepsy of childhood seizures are rarely recorded during routine EEG, probably because seizures occur during the early morning part of the sleep cycle, which may differ from the brief nap during routine EEG. There was concurrence of generalized spike and wave discharges in these patients. It is unclear whether this is related to a common pathophysiologic factor.
鲜有关于良性局灶性癫痫样放电患者发作期记录的报道。本研究旨在评估此类记录的发生频率,并描述其临床和电生理表现。我们对 10 年间行常规脑电图(EEG)加视频监测的所有患者进行了回顾性图表审查。在 214 例良性局灶性癫痫样放电患者中,有 5 例患者的 EEG 记录到癫痫发作(2.3%)。癫痫综合征包括 1 例儿童良性癫痫,3 例儿童失神癫痫,1 例同时存在上述两种。在 214 例患者中,仅有 1 例(0.4%)的癫痫发作具有儿童良性癫痫的特征。文献复习显示,儿童失神癫痫和儿童良性癫痫或良性局灶性癫痫样放电可能在同一患者中同时存在。这些发现表明,在常规 EEG 中很少记录到儿童良性癫痫发作,这可能是因为发作发生在睡眠周期的清晨部分,这可能与常规 EEG 期间的短暂小睡不同。这些患者均存在全面性棘慢波放电。尚不清楚这是否与共同的病理生理因素有关。