Patel Nehal H, Jain Ashish R, Iyer Vivek K, Shah Anand G, Jain Dipti A, Shah Anjanaben A
Department of Pediatrics, GMERS Medical College Sola, Ahmedabad, Gujarat, India.
Ann Indian Acad Neurol. 2013 Jul;16(3):352-6. doi: 10.4103/0972-2327.116928.
Therapeutic relevance of computed tomography (CT) in children with partial seizures is reported to be remarkably low (1-2%). However, in the developing countries where infections involving the nervous system are common, routine CT scan of brain may help in finding treatable causes of seizures.
Aim of this study was to evaluate the significance of CT scan of brain in the management of children with partial seizures.
Children with partial epilepsy, whose predominant seizure type was focal motor seizures, were included in the study. CT scan of brain was done in all children aged between 1 month and 12 years with partial seizures of unknown etiology prospectively. The clinical findings of these children were noted along with the CT findings.
Between August 2001 and July 2002, of the 200 children with seizure disorder 50 children who satisfied the inclusion criteria were included in the study. CT scan of brain was normal in 16 children (32%) and was abnormal in 34 children (68%). Twenty children (~60% of abnormal scan) had potentially correctable lesions: Tuberculoma (n = 13), neurocysticercosis (n = 3), and brain abscess (n = 4). Five children had changes representing static pathology that did not influence patient management. The clinical features correlated with CT findings in 78% children.
Children with partial motor seizures have high probability of having abnormal findings on CT scan of brain, especially, neuro-infections which are potentially treatable. Therefore, CT scan brain should be carried out in all children with partial motor seizures especially, in developing countries.
据报道,计算机断层扫描(CT)在部分性癫痫患儿中的治疗相关性非常低(1%-2%)。然而,在神经系统感染常见的发展中国家,常规脑部CT扫描可能有助于发现可治疗的癫痫病因。
本研究旨在评估脑部CT扫描在部分性癫痫患儿管理中的意义。
纳入以局灶性运动性癫痫为主要发作类型的部分性癫痫患儿。对所有年龄在1个月至12岁、病因不明的部分性癫痫患儿进行前瞻性脑部CT扫描。记录这些患儿的临床发现以及CT结果。
在2001年8月至2002年7月期间,200例癫痫患儿中有50例符合纳入标准并被纳入研究。16例患儿(占32%)的脑部CT扫描结果正常,34例患儿(占68%)的结果异常。20例患儿(约占异常扫描患儿的60%)有潜在可纠正的病变:结核瘤(13例)、脑囊尾蚴病(3例)和脑脓肿(4例)。5例患儿有代表静止性病变的改变,不影响患者的治疗管理。78%的患儿临床特征与CT结果相关。
部分性运动性癫痫患儿脑部CT扫描出现异常结果的可能性很高,尤其是潜在可治疗的神经感染。因此,所有部分性运动性癫痫患儿都应进行脑部CT扫描,特别是在发展中国家。