Ohtsuka Y, Amano R, Mizukawa M, Ohtahara S
Department of Child Neurology, Okayama University Medical School, Japan.
Jpn J Psychiatry Neurol. 1990 Jun;44(2):257-64. doi: 10.1111/j.1440-1819.1990.tb01404.x.
A long-term follow-up study of 89 patients of Lennox-Gastaut syndrome (LGS) disclosed the persistent occurrence of seizures in 68 patients (76.4%) and severe mental defect in 48 (53.9%). An analysis of the correlation between the mental and seizure prognoses confirmed that the persistence of minor seizures could result in mental deterioration. An examination of the evolutional changes in EEG demonstrated that diffuse slow spike-waves characteristic of LGS gradually disappeared, while focal epileptic discharges, especially multifocal spikes, appeared in spite of the persistence of minor seizures. The diagnostic criteria were satisfied in only 31 (47.0%) of 66 patients with the persistence of minor seizures. Patients with multiple independent spike foci and minor seizures were considered to belong to a specific type of epilepsy, namely the severe epilepsy with multiple independent spike foci (the severe epilepsy with MISF). The seizure and mental prognoses were poorer in patients who evolved into the severe epilepsy with MISF than others.
一项对89例伦诺克斯 - 加斯东综合征（LGS）患者的长期随访研究发现，68例患者（76.4%）持续出现癫痫发作，48例患者（53.9%）存在严重智力缺陷。对智力和癫痫预后相关性的分析证实，轻微癫痫发作的持续可能导致智力衰退。对脑电图演变变化的检查表明，LGS特有的弥漫性慢棘波逐渐消失，尽管仍有轻微癫痫发作，但局灶性癫痫放电，尤其是多灶性棘波出现。在66例有轻微癫痫发作持续的患者中，仅31例（47.0%）符合诊断标准。有多个独立棘波灶和轻微癫痫发作的患者被认为属于一种特定类型的癫痫，即伴有多个独立棘波灶的严重癫痫（MISF严重癫痫）。演变为MISF严重癫痫的患者其癫痫发作和智力预后比其他患者更差。
