Department of Clinical Neurophysiology, Royal Hallamshire Hospital, Sheffield, UK.
Dev Med Child Neurol. 2012 Nov;54(11):1001-5. doi: 10.1111/j.1469-8749.2012.04337.x. Epub 2012 Jun 19.
Hyperventilation-induced high-amplitude rhythmic slow activity with altered awareness (HIHARS) is increasingly being identified in children and is thought to be an age-related non-epileptic electrographic phenomenon. We retrospectively investigated the clinical outcome in 15 children (six males, nine females) with HIHARS (mean age 7y, SD 1y 11mo; range 4y 6mo-11y). The presenting feature in 11 cases was blank spells - two of these children also had generalized tonic-clonic seizures (GTCS) - and in one individual the main concern was deteriorating school performance. Three children had symptoms suggestive of focal motor seizures. Of the nine children presenting solely with blank spells, further follow-up (mean duration 18mo, SD 21mo) revealed full resolution of symptoms in six, but three had persistent symptoms. In our study, the symptoms of children with HIHARS presenting with blank spells in isolation appeared to resolve spontaneously and did not evolve into convulsive seizures or other paroxysmal events considered to be clearly epileptic. Children (with HIHARS) who presented with clinical features suggestive of GTCS or focal motor seizures (with or without blank spells) and/or had epileptiform discharges on interictal electroencephalography were subsequently diagnosed with epilepsy.
过度通气诱导的高振幅节律性慢波活动伴意识改变（HIHARS）在儿童中越来越多地被发现，被认为是一种与年龄相关的非癫痫性脑电图现象。我们回顾性研究了 15 名 HIHARS 患儿（男 6 例，女 9 例；平均年龄 7 岁，标准差 1 岁 11 个月；范围 4 岁 6 个月-11 岁）的临床转归。11 例患儿的首发症状为空白发作 - 其中 2 例患儿还伴有全面强直阵挛发作（GTCS） - 1 例患儿主要表现为学习成绩下降。3 例患儿有局灶性运动性癫痫发作的症状。9 例单纯以空白发作为首发症状的患儿中，进一步随访（平均随访时间 18 个月，标准差 21 个月）显示 6 例症状完全缓解，但 3 例仍有持续症状。在我们的研究中，孤立性出现 HIHARS 症状的患儿的症状似乎会自发缓解，不会发展为被认为是明确癫痫的惊厥性发作或其他阵发性事件。出现 GTCS 或局灶性运动性癫痫发作（伴有或不伴有空白发作）临床特征且/或在发作间期脑电图上有癫痫样放电的患儿随后被诊断为癫痫。
