IRCCS Centro Neurolesi Bonino-Pulejo, Via Palermo, SS 113, C.da Casazza, 98124 Messina, Italy.
Epilepsy Res. 2010 May;89(2-3):271-7. doi: 10.1016/j.eplepsyres.2010.01.012. Epub 2010 Feb 10.
We performed a retrospective study to investigate seizure, EEG, social and cognitive outcome in adult LGS subjects.
We retrospectively evaluated 27 LGS patients aged 40-59 years. We assessed in particular the evolution of different seizure types and EEG findings, as well as cognitive and social outcome.
During the early stages of the disease, all patients presented tonic seizures (TS) during wakefulness and sleep, 20/27 had atypical absences (AA), more rarely other seizure types. EEG showed slow background activity in 21/27 patients, diffuse slow spike-wave discharges (DSSW) during wakefulness in 22/27, and bursts of diffuse fast rhythms (DFR) in sleep in all patients. At last observation, 11 patients only had TS during wakefulness, but all still presented TS during sleep; AA persisted in 6 patients. EEG showed normal BA in 12/27 patients; only 7/27 still presented DSSW. On the contrary, sleep EEG showed the persistence of DFR in all. A moderate to severe cognitive impairment was observed in 26/27 patients.
In adult LGS patients TS during sleep remain the major seizure type; moreover, a standard waking EEG may be normal. Thus, polysomnography represents the most important mean of investigation also in adult LGS patients.
我们进行了一项回顾性研究，以调查成年 LGS 患者的癫痫发作、脑电图、社会和认知结局。
我们回顾性评估了 27 名年龄在 40-59 岁的 LGS 患者。我们特别评估了不同癫痫发作类型和脑电图表现的演变，以及认知和社会结局。
在疾病的早期阶段，所有患者在清醒和睡眠时都出现强直发作（TS），27 例中有 20 例出现非典型失神（AA），其他发作类型较少见。脑电图显示 27 例中有 21 例背景活动缓慢，27 例中有 22 例在清醒时出现弥漫性慢棘慢波放电（DSSW），所有患者在睡眠时出现弥漫性快节律爆发（DFR）。最后一次观察时，11 例患者仅在清醒时出现 TS，但仍有所有患者在睡眠时出现 TS；6 例患者仍存在 AA。脑电图显示 27 例中有 12 例正常背景活动；仅 7 例仍存在 DSSW。相反，睡眠脑电图显示 DFR 在所有患者中均持续存在。27 例患者中有 26 例存在中度至重度认知障碍。
在成年 LGS 患者中，睡眠中的 TS 仍然是主要的癫痫发作类型；此外，清醒时的标准脑电图可能正常。因此，多导睡眠图是成年 LGS 患者最重要的研究手段。
