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35例偏瘫惊厥综合征的临床特征、神经影像学及脑电图表现

Clinical aspects, neuroimaging, and electroencephalography of 35 cases of hemiconvulsion-hemiplegia syndrome.

作者信息

Albakaye Mohamed, Belaïdi Halima, Lahjouji Fatiha, Errguig Leila, Kuate Callixte, Maiga Youssoufa, Diallo Seybou Hassane, Kissani Najib, Ouazzani Reda

机构信息

Clinical Neurophysiology Department, Specialty Hospital, Rabat, Morocco; Neurology Department, CHU Mohammed VI, Marrakesh 40000, Morocco.

Clinical Neurophysiology Department, Specialty Hospital, Rabat, Morocco.

出版信息

Epilepsy Behav. 2018 Mar;80:184-190. doi: 10.1016/j.yebeh.2017.12.018. Epub 2018 Feb 3.

DOI:10.1016/j.yebeh.2017.12.018
PMID:29414550
Abstract

INTRODUCTION

The hemiconvulsion-hemiplegia-epilepsy (HHE) syndrome is a rare consequence of febrile seizures during childhood. It is characterized by the presence of prolonged unilateral clonic seizures occurring during febrile illness in a child less than 4years of age. Then, a flaccid unilateral hemiplegia with variable duration occurs.

OBJECTIVES

The objective of the study was to describe the clinical, electroencephalogram (EEG), and neuroimaging treatment and outcome of series of cases of HHE syndrome followed for 10years in our clinical neurophysiology department of the specialty hospital of Rabat.

PATIENTS AND METHODS

We report a retrospective study of 35 patients followed up for HHE syndrome from January 2005 to December 2015. All patients included in the study met the definition criteria for HHE syndrome.

RESULTS

The age of onset ranged from 1 to 10years. Hemiplegia or spastic hemiparesis of the ipsilateral side to the convulsion was present in all patients. Abnormal brain magnetic resonance imaging (MRI) was found in all patients. All patients developed drug-resistant focal epilepsy during the course of the disease.

CONCLUSIONS

The management of HHE syndrome constitutes a real public health problem in developing countries like Morocco. The neurological morbidity and the severe sequels are of high impact in these young kids. On the one hand, authors highlight the need for improving emergency care of status epilepticus. On the other hand, in our context, the prophylaxis of febrile seizures seems to be the corner stone of the prevention of HHE Syndrome.

摘要

引言

偏瘫-偏瘫-癫痫(HHE)综合征是儿童热性惊厥的一种罕见后果。其特征是在4岁以下儿童发热性疾病期间出现长时间的单侧阵挛性发作。然后,出现持续时间不等的弛缓性单侧偏瘫。

目的

本研究的目的是描述在拉巴特专科医院临床神经生理科随访10年的一系列HHE综合征病例的临床、脑电图(EEG)、神经影像学表现、治疗及预后。

患者与方法

我们报告了一项对2005年1月至2015年12月期间随访的35例HHE综合征患者的回顾性研究。纳入研究的所有患者均符合HHE综合征的定义标准。

结果

发病年龄为1至10岁。所有患者均出现与惊厥同侧的偏瘫或痉挛性偏瘫。所有患者的脑磁共振成像(MRI)均异常。所有患者在病程中均发展为药物难治性局灶性癫痫。

结论

在摩洛哥这样的发展中国家,HHE综合征的管理是一个切实的公共卫生问题。这些幼儿的神经发病率和严重后遗症影响很大。一方面,作者强调需要改善癫痫持续状态的急诊护理。另一方面,在我们的情况下,热性惊厥的预防似乎是预防HHE综合征的基石。

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