Igarashi Ayuko, Okumura Akihisa, Komatsu Mitsutaka, Tomita Osamu, Abe Shinpei, Ikeno Mitsuru, Saito Masako, Nakazawa Tomoyuki, Shimizu Toshiaki
Department of Pediatrics, Juntendo University Faculty of Medicine, Japan.
Department of Pediatrics, Juntendo University Faculty of Medicine, Japan.
Eur J Paediatr Neurol. 2014 Nov;18(6):806-10. doi: 10.1016/j.ejpn.2014.07.003. Epub 2014 Aug 1.
We describe the clinical course and amplitude-integrated EEG findings in three children with non-accidental head injury and discuss on the importance of continuous aEEG monitoring in infants.
NCSE was defined as a continuous 30-min seizure or briefer seizures occurring consecutively comprising at least 30 min of any 1-h period. Non-accidental head injury was diagnosed on the basis of neuroimaging findings such as subdural hemorrhage. Antiepileptic treatment was performed with continuous amplitude-integrated EEG monitoring.
The age of the patients ranged from 48 days to nine months. All of them had loss of consciousness and seizures on presentation. Nonconvulsive status epilepticus without clinical symptoms were recognized in all patients. Vigorous antiepileptic treatment against nonconvulsive status epilepticus was made in two patients, whereas nonconvulsive status epilepticus disappeared within one hour without additional treatment in one.
Our experience indicates that nonconvulsive status epilepticus were not uncommon in children with non-accidental head injury. Continuous amplitude-integrated EEG monitoring will be one of the useful methods in encephalopathic children in order to estimate seizure burden objectively and to treat seizures appropriately.
我们描述了三名非意外性头部损伤儿童的临床病程及振幅整合脑电图（aEEG）结果，并讨论了对婴儿进行连续aEEG监测的重要性。
非惊厥性癫痫持续状态（NCSE）定义为持续30分钟的癫痫发作或连续出现的较短癫痫发作，在任何1小时时间段内至少持续30分钟。根据诸如硬膜下出血等神经影像学检查结果诊断非意外性头部损伤。采用连续振幅整合脑电图监测进行抗癫痫治疗。
患者年龄在48天至9个月之间。所有患者就诊时均有意识丧失和癫痫发作。所有患者均被识别出无临床症状的非惊厥性癫痫持续状态。两名患者针对非惊厥性癫痫持续状态进行了积极的抗癫痫治疗，而一名患者未经额外治疗在1小时内非惊厥性癫痫持续状态消失。
我们的经验表明，非惊厥性癫痫持续状态在非意外性头部损伤儿童中并不少见。连续振幅整合脑电图监测将是脑病患儿客观评估癫痫发作负荷并适当治疗癫痫发作的有用方法之一。
