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左乙拉西坦治疗 Lennox-Gastaut 综合征的疗效。病例报告。

Levetiracetam efficacy in patients with Lennox-Gastaut syndrome. Presentation of a case.

机构信息

Servicio de Neurología, Hospital Infanta Elena, Valdemoro, Madrid, España.

出版信息

Neurologia. 2011 Jun;26(5):285-90. doi: 10.1016/j.nrl.2010.10.012. Epub 2011 Feb 24.

Abstract

INTRODUCTION

The Lennox-Gastaut syndrome (LGS) is one of the most severe epileptic encephalopathies of childhood, characterized by electro-clinical triad of generalized spike-wave activity, slow (POL) in the electroencephalogram (EEG), multiple types of seizures and development delay. This paper intends to describe the syndrome in a patient with a history of hypoxic-ischaemic encephalopathy and Lennox-Gastaut syndrome, and a good response to treatment with levetiracetam (LEV).

METHOD

Descriptive study on the development of a 3 year old child with intrauterine asphyxia, multiorgan failure, metabolic acidosis, hypovolemic shock, and seizures with cerebral oedema, who developed a West syndrome, resistant to drug treatment. The semiology of seizures progressively changed to generalized episodes of hypertonia and myoclonus, with slow spike-wave electroencephalographic activity.

RESULTS

With the diagnosis of Lennox-Gastaut syndrome the patient was treated with levetiracetam, showing a substantial improvement in the cognitive sphere, in the control of seizures, and electroencephalographic findings.

CONCLUSIONS

Lennox-Gastaut syndrome is one of the most severe epileptic syndromes in paediatric patients. Levetiracetam can help cognitive improvement, and contribute to seizure control in these patients.

摘要

简介

Lennox-Gastaut 综合征(LGS)是儿童时期最严重的癫痫性脑病之一,其特征为全身性棘慢波活动、脑电图(EEG)中的慢波(POL)、多种类型的癫痫发作和发育迟缓的电临床三联征。本文旨在描述一名患有缺氧缺血性脑病和 Lennox-Gastaut 综合征病史的患者的综合征,以及对左乙拉西坦(LEV)治疗反应良好的情况。

方法

对一名 3 岁儿童的发育情况进行描述性研究,该儿童宫内窒息,多器官衰竭,代谢性酸中毒,低血容量性休克,伴有脑水肿的癫痫发作,发展为 West 综合征,对药物治疗有耐药性。癫痫发作的症状逐渐转变为全身性张力过高和肌阵挛发作,伴有慢棘慢波的脑电图活动。

结果

诊断为 Lennox-Gastaut 综合征后,该患者接受了左乙拉西坦治疗,在认知领域、癫痫发作控制和脑电图发现方面均有显著改善。

结论

Lennox-Gastaut 综合征是儿童中最严重的癫痫综合征之一。左乙拉西坦可以帮助改善认知,并有助于控制这些患者的癫痫发作。

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