McAbee G N, Barasch E S, Kurfist L A
Department of Neurology, Nassau County Medical Center, East Meadow, NY 11554.
Pediatr Neurol. 1989 Mar-Apr;5(2):102-6. doi: 10.1016/0887-8994(89)90034-9.
A combined retrospective and prospective study assessed the results of computed tomographic (CT) scans in infants and children without neurologic deficit who presented with initial onset of seizures. Of 101 pediatric patients, 81 had afebrile seizures and 20 had complicated febrile seizures (i.e., focal, multiple, or prolonged). Seven children (7%), 6 with afebrile and 1 with a febrile seizure, had CT abnormalities. Four patients (4%) required further diagnostic workup including angiography and/or surgery. Children with afebrile focal seizures were more likely to have an abnormality than those with afebrile generalized seizures without focal components (13% and 4.9%, respectively). This study demonstrated a lower percentage of overall CT abnormalities, yet a similar percentage of "therapeutically important" abnormalities, in neurologically normal children with new onset of seizures when compared to previous reports of children with chronic seizures. Although an abnormal CT was more likely to be associated with an abnormal electroencephalogram, a normal result did not eliminate the possibility of an abnormal CT.
一项回顾性与前瞻性相结合的研究评估了无神经功能缺损、首次发作癫痫的婴幼儿及儿童的计算机断层扫描（CT）结果。在101例儿科患者中，81例为无热惊厥，20例为复杂性热性惊厥（即局灶性、多发性或持续性惊厥）。7名儿童（7%）CT检查异常，其中6名无热惊厥，1名热性惊厥。4例患者（4%）需要进一步的诊断检查，包括血管造影和/或手术。无热局灶性惊厥患儿比无局灶成分的无热全身性惊厥患儿更易出现异常（分别为13%和4.9%）。与既往关于慢性癫痫患儿的报道相比，本研究显示，新发癫痫的神经功能正常儿童中，总体CT异常的比例较低，但“具有治疗重要性”的异常比例相似。虽然CT异常更可能与脑电图异常相关，但正常结果并不能排除CT异常的可能性。
