McEnery P T, Nathan J, Bates S R, Daniels S R
Children's Hospital Medical Center, Division of Nephrology, Cincinnati, OH 45229-2899.
J Pediatr. 1989 Oct;115(4):532-6. doi: 10.1016/s0022-3476(89)80276-8.
We reviewed the records of 154 children who received 207 renal transplants for end-stage renal disease from 1965 to 1987, and discovered that 48 (31%) had had convulsive seizures, some before transplant surgery, others only after transplant, and some during both before and after transplantation. The majority of children had minimal long-term problems, and 60% of the children had only a single convulsion. In six of the patients, convulsions were a manifestation of more serious underlying conditions that produced significant morbidity. Seizures of differing clinical type occurred, with hypertension being the most significant etiologic factor. In children with renal failure, there are minimal symptoms heralding the hypertensive encephalopathy. Rapid resolution without recurrence of seizures after control of hypertension is a major sign that hypertension was the cause and that the long-term prognosis is good.
我们回顾了1965年至1987年间因终末期肾病接受207例肾移植的154名儿童的记录，发现48名（31%）曾有惊厥发作，有些在移植手术前，有些仅在移植后，还有些在移植前后均有发作。大多数儿童长期问题较少，60%的儿童仅有一次惊厥发作。在6名患者中，惊厥是更严重的基础疾病的表现，这些疾病导致了显著的发病率。出现了不同临床类型的癫痫发作，高血压是最重要的病因。在肾衰竭儿童中，先兆高血压脑病的症状很少。控制高血压后癫痫发作迅速缓解且不再复发是高血压为病因且长期预后良好的主要标志。
