Xue Jiao, Qian Ping, Li Hui, Yang Haipo, Liu Xiaoyan, Zhang Yuehua, Yang Zhixian
Department of Pediatrics, Peking University First Hospital, Beijing, China.
Department of Pediatrics, Peking University First Hospital, Beijing, China.
Clin Neurophysiol. 2017 Jan;128(1):220-226. doi: 10.1016/j.clinph.2016.11.008. Epub 2016 Nov 20.
To study the atonic elements combined or uncombined with epileptic spasms in infantile spasms.
The demographic data, clinical characteristics, electroencephalogram (EEG), and polyelectromyography (PEMG) features were analyzed in 12 infantile spasm patients with atonic elements.
A total of 29 EEGs were recorded. Hypsarrhythmia or hypsarrhythmia variants were identified during interictal EEG. Insular or clustered epileptic spasms occurred in all. Three subtypes of atonic elements combined or uncombined with epileptic spasms (spasm-atonic, pure atonic, and atonic-spasm seizures) were observed electroclinically, which could present insularly or in cluster or altered with epileptic spasms in the same cluster. The ictal EEG showed generalized high-amplitude slow waves presenting alone or combined with other patterns. The corresponding PEMG showed an obvious electrical silence alone or preceding or following a crescendo-decrescendo pattern generated from myoelectric burst.
Atonic elements combined or uncombined with epileptic spasms was a newly noticed phenomenon in infantile spasms, which was artificially divided into three subtypes here. It might be a variant of epileptic spasms or a unique seizure type.
Atonic elements combined or uncombined with epileptic spasms was a previously ignored phenomenon in infantile spasms, which should be seriously considered in clinical practice.
研究婴儿痉挛症中与癫痫性痉挛合并或未合并的失张力成分。
对12例伴有失张力成分的婴儿痉挛症患者的人口统计学数据、临床特征、脑电图（EEG）和多导肌电图（PEMG）特征进行分析。
共记录了29份脑电图。在发作间期脑电图中发现高峰节律紊乱或高峰节律紊乱变异型。均出现局灶性或成簇性癫痫性痉挛。在电临床观察到失张力成分与癫痫性痉挛合并或未合并的三种亚型（痉挛 - 失张力型、单纯失张力型和失张力 - 痉挛发作型），可呈局灶性、成簇性出现或在同一簇中随癫痫性痉挛而改变。发作期脑电图显示单独出现或与其他模式合并的广泛性高幅慢波。相应的PEMG显示单独出现明显电静息，或在肌电爆发产生的渐强 - 渐弱模式之前或之后出现。
失张力成分与癫痫性痉挛合并或未合并是婴儿痉挛症中一种新发现的现象，在此人为地分为三种亚型。它可能是癫痫性痉挛的一种变异型或一种独特的发作类型。
失张力成分与癫痫性痉挛合并或未合并是婴儿痉挛症中一种先前被忽视的现象，在临床实践中应予以认真考虑。
