Takahashi I, Miura K, Nomura K, Furune S, Maehara M, Negoro T, Watanabe K
Department of Pediatrics, Nagoya University, Japan.
Brain Dev. 1990;12(5):498-502. doi: 10.1016/s0387-7604(12)80215-4.
We studied the clinical course and seizure prognosis of 126 children with complex partial seizures regularly followed up for more than 4 years in our clinic. Clinical and EEG features of 63 seizure-free patients were compared with those of 63 patients with persistent seizures. The features contributing to poor prognosis were 1) mental retardation, 2) a history of status epilepticus and 3) abnormal basic rhythm in EEG. CT abnormality, a history of febrile convulsions (FC), the clustering of seizures and association with other types of seizures did not influence prognosis. We divided the patients into four groups according to the evolutionary pattern of seizure discharges: Group A, 55 (43.7%) patients with spike focus always fixed in the same region; Group B, 20 (15.9%) patients with wandering foci; Group C, 10 (7.4%) patients with multifocal spikes; and group D, 41 (32.5%) patients with no focal discharges. There was no difference in seizure prognosis among these four groups, but the patients with a focus in the anterior temporal region in Group A evidenced the worst prognosis.
我们研究了在我院定期随访4年以上的126例复杂部分性发作儿童的临床病程和癫痫发作预后。将63例无癫痫发作患者的临床和脑电图特征与63例持续性癫痫发作患者的特征进行了比较。导致预后不良的特征为：1）智力低下；2）癫痫持续状态病史；3）脑电图基本节律异常。CT异常、热性惊厥（FC）病史、癫痫发作成簇以及与其他类型癫痫发作相关均不影响预后。根据癫痫放电的演变模式，我们将患者分为四组：A组，55例（43.7%），棘波灶始终固定在同一区域；B组，20例（15.9%），有游走性病灶；C组，10例（7.4%），有多灶性棘波；D组，41例（32.5%），无局灶性放电。这四组之间的癫痫发作预后无差异，但A组前颞叶区域有病灶的患者预后最差。
