Neurology and Epileptology Department, The Children's Memorial Health Institute, Warsaw, Poland.
Epilepsia. 2010 Jul;51(7):1212-8. doi: 10.1111/j.1528-1167.2009.02467.x. Epub 2009 Dec 22.
A prospective study estimating antiepileptic and antiviral regimens administered to infants with symptomatic epilepsy and human cytomegalovirus (HCMV) neuroinfection followed for at least 4 years.
Thirty-two infants (19 female, 13 male) with epileptic seizures and HCMV neuroinfection diagnosed during the first year of life. Detection of HCMV DNA by qualitative polymerase chain reaction (PCR) method in cerebrospinal fluid (CSF), blood leukocytes, and urine confirmed the diagnosis. Infants were treated with intravenous ganciclovir (GCV) and different antiepileptic drugs. All had multiple electroencephalographic and neuroimaging examinations. Outcome of seizures was assessed using Engel classification system in the child's fourth year of life.
Cessation of seizures was achieved in 19 infants (59.4%). In 11 children (34.4%) it was possible to withdraw administration of AEDs after 30-36 months. No infantile spasms, generalized tonic-clonic seizures, or polymorphic seizures were observed. They remained seizure-free for 1-6 years without relapse and their psychomotor development was normal. Four patients with intractable epilepsy (class V) had the longest GCV treatment (median 8 weeks). GCV treatment was implemented at the time or within 1 month after the onset of epileptic seizures in 10 of 11 infants withdrawn from AEDs.
Early introduction of antiepileptic and antiviral GCV regimens in epilepsy and CMV neuroinfection may result in discontinuation of antiepileptic treatment and normal psychomotor development in infants.
一项前瞻性研究估计了接受抗病毒和抗癫痫治疗的伴有症状性癫痫和人巨细胞病毒（HCMV）神经感染的婴儿的方案，这些婴儿的随访时间至少为 4 年。
32 名（19 名女性，13 名男性）在生命的第一年被诊断患有癫痫发作和 HCMV 神经感染的婴儿。通过脑脊液（CSF）、白细胞和尿液的定性聚合酶链反应（PCR）方法检测 HCMV DNA 来确诊。婴儿接受静脉注射更昔洛韦（GCV）和不同的抗癫痫药物治疗。所有婴儿都进行了多次脑电图和神经影像学检查。在孩子的第四年，使用 Engel 分类系统评估癫痫发作的结果。
19 名婴儿（59.4%）癫痫发作停止。在 11 名儿童（34.4%）中，在 30-36 个月后可以停止使用 AED。未观察到婴儿痉挛、全面强直阵挛性发作或多形性发作。他们在没有复发的情况下保持无癫痫发作 1-6 年，并且他们的精神运动发育正常。4 名难治性癫痫患儿（V 类）的 GCV 治疗时间最长（中位数 8 周）。在 11 名从 AED 停药的婴儿中，有 10 名在癫痫发作开始时或 1 个月内开始接受 GCV 治疗。
在癫痫和 CMV 神经感染中早期引入抗癫痫和抗病毒 GCV 方案可能导致婴儿停止抗癫痫治疗和正常精神运动发育。
