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[肌阵挛-失张力癫痫的电临床特征]

[Electroclinical features of myoclonic-atonic epilepsy].

作者信息

Deng Jie, Zhang Yue-hua, Liu Xiao-yan, Yang Zhi-xian, Xiong Hui, Wang Shuang, Bao Xin-hua, Jiang Yu-wu, Qin Jiong, Lin Qing, Wu Xi-ru

机构信息

Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.

出版信息

Zhonghua Er Ke Za Zhi. 2011 Aug;49(8):577-82.

PMID:22093418
Abstract

OBJECTIVE

To summarize the electroclinical characteristics of myoclonic atonic epilepsy (MAE) in children.

METHOD

The clinical data, video electroencephalogram (EEG) and simultaneous electromyography (EMG) of MAE patients were analyzed. The treatment and its effects were followed up.

RESULT

In 47 MAE patients, 25 had a history of febrile seizures (FS), 20 had a family history of FS or epilepsy. All patients had a normal development before the illness. The age of afebrile seizure onset was between 1.4 years to 5.8 years. The first seizure was generalized tonic-clonic seizure (GTCS) in 41 patients (87.2%). All patients had multiple seizure types, including 47 GTCS (97.9%), 34 myoclonic atonic seizures (72.3%), 47 myoclonic seizures (100%), 32 atonic seizures (68.1%), 36 atypical absences (76.6%) and 3 tonic seizures (6.4%). EEG backgrounds were slow or parietal θ rhythm, interictal EEG showed 1-4 Hz (predominant 2-3 Hz) generalized spike and wave or poly spike and wave discharges in all cases. Seizures were controlled by antiepileptic drugs (AEDs) in 41 patients (87.2%). Valproate was used in 37. Lamotrigine was used in 26. Mild mental retardation was observed in 10 children after the onset of the illness.

CONCLUSION

The clinical features of MAE included the following: the development was normal before the onset of the illness; the onset of seizure type was often GTCS. All patients had multiple generalized seizure types. Myoclonic atonic seizure was its characteristic seizure type. EEG showed generalized discharges. Early diagnosis and rational choice of AEDs are important for getting a better prognosis.

摘要

目的

总结儿童肌阵挛失张力癫痫(MAE)的临床电生理特征。

方法

分析MAE患者的临床资料、视频脑电图(EEG)及同步肌电图(EMG),并对治疗及其效果进行随访。

结果

47例MAE患者中,25例有热性惊厥(FS)病史,20例有FS或癫痫家族史。所有患者病前发育正常。无热惊厥发病年龄在1.4岁至5.8岁之间。41例患者(87.2%)首次发作是全面性强直阵挛发作(GTCS)。所有患者均有多种发作类型,包括47次GTCS(97.9%)、34次肌阵挛失张力发作(72.3%)、47次肌阵挛发作(100%)、32次失张力发作(68.1%)、36次不典型失神发作(76.6%)和3次强直发作(6.4%)。脑电图背景为慢波或顶叶θ节律,发作间期脑电图在所有病例中均显示1 - 4Hz(以2 - 3Hz为主)的全面性棘波和慢波或多棘慢波放电。41例患者(87.2%)的癫痫发作被抗癫痫药物(AEDs)控制。37例使用丙戊酸盐,26例使用拉莫三嗪。10例患儿发病后出现轻度智力发育迟缓。

结论

MAE的临床特征如下:病前发育正常;发作类型常为GTCS。所有患者均有多种全面性发作类型。肌阵挛失张力发作是其特征性发作类型。脑电图显示全面性放电。早期诊断和合理选择AEDs对获得较好预后很重要。

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