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[儿童视觉性癫痫发作的临床特征、鉴别诊断及演变]

[Clinical aspects, differential diagnosis and evolution of visual epileptic seizures in children].

作者信息

Nalin A, Ruggerini C, Ferrari E, Galli V, Ferrari P, Finelli T

机构信息

Service de neuropsychiatrie infantile et Service de pédiatrie du Centre hospitalier universitaire de Modena, Italie.

出版信息

Neurophysiol Clin. 1989 Mar;19(1):25-36. doi: 10.1016/s0987-7053(89)80082-6.

Abstract

We studied 13 boys and girls, treated for ictal visual episodes, followed-up in the Center for Epilepsy of the University of Modena. In 10 cases visual symptoms (amaurosis, hallucinations, and illusions) started between 6 and 14 years, associated with occipital EEG anomalies. In 6 cases, EEG abnormalities (sharp-waves, slow waves, spikes, spike-waves) disappeared after eyes opening. In the history of half of our cases, there was no significant antecedent. Normal intelligence and behaviour were present in all cases. Only in one case, CT demonstrated bilateral occipital calcifications. In the other 9, visual ictal symptoms disappeared after antiepileptic treatment. We think that these last cases present the characteristic features of Benign Occipital Epilepsy described by Gastaut (1982-1985). On the basis of our results, we can confirm the existence of this syndrome, even if it is rare. Nevertheless, 3 of our cases with visual symptoms, don't show the typical picture of BOE, and must be diagnostically distinguished from psychiatric disorders, basilar migraine, and other partial epilepsies.

摘要

我们研究了13名因发作性视觉症状接受治疗的男孩和女孩,他们在摩德纳大学癫痫中心接受随访。10例患者的视觉症状(黑矇、幻觉和错觉)始于6至14岁,伴有枕叶脑电图异常。6例患者的脑电图异常(尖波、慢波、棘波、棘慢波)在睁眼后消失。在我们一半的病例史中,没有明显的前驱症状。所有病例智力和行为均正常。仅1例患者CT显示双侧枕叶钙化。其他9例患者在接受抗癫痫治疗后视觉发作症状消失。我们认为这些最后的病例呈现出加斯陶(1982 - 1985年)所描述的良性枕叶癫痫的特征。基于我们的结果,我们可以确认这种综合征的存在,尽管它很罕见。然而,我们3例有视觉症状的病例并未表现出典型的良性枕叶癫痫症状图像,必须在诊断上与精神障碍、基底型偏头痛和其他部分性癫痫相鉴别。

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