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热性惊厥后癫痫样放电对后续癫痫的预测价值

Predictive Value of Epileptiform Discharges for Subsequent Epilepsy After Febrile Seizures.

作者信息

Kavčič Alja, Rener-Primec Zvonka

机构信息

1 Faculty of Medicine, University of Ljubljana, Slovenia.

2 Department of Child, Adolescent and Developmental Neurology, Children's Hospital, University Medical Center Ljubljana, Slovenia.

出版信息

J Child Neurol. 2018 Oct;33(12):772-775. doi: 10.1177/0883073818787064. Epub 2018 Jul 19.

Abstract

The predictive value of epileptiform discharges for subsequent epilepsy after febrile seizures was studied in 140 children: 72 children (51%) had simple febrile seizures and 68 children (49%) had complex febrile seizures. Electroencephalography (EEG) was performed in 103 children (74%), it was normal in 66 (47%) and with epileptiform patterns in 37 patients (26%). At follow-up in 2017, 10 children developed epilepsy, 1 had a single epileptic seizure, 9 of them had epileptiform EEGs. Of the patients with normal EEGs after complex febrile seizures, none developed epilepsy, and 92% of patients with normal EEGs after recurrent febrile seizures did not develop epilepsy. Therefore, patients with normal EEGs were unlikely to develop epilepsy. Fifteen percent of patients with complex and 31% of patients with recurrent febrile seizures and epileptiform EEGs developed epileptic seizures. The positive predictive value of epileptiform discharges was low in complex and twice as high in recurrent febrile seizures.

摘要

对140名儿童进行了研究,以探讨热性惊厥后癫痫样放电对后续癫痫的预测价值:72名儿童(51%)发生单纯热性惊厥,68名儿童(49%)发生复杂性热性惊厥。103名儿童(74%)进行了脑电图(EEG)检查,其中66名(47%)结果正常,37名患者(26%)有癫痫样波形。在2017年的随访中,10名儿童发生癫痫,1名仅有一次癫痫发作,其中9名有癫痫样脑电图。复杂性热性惊厥后脑电图正常的患者中,无人发生癫痫,复发性热性惊厥后脑电图正常的患者中,92%未发生癫痫。因此,脑电图正常的患者不太可能发生癫痫。复杂性热性惊厥患者中有15%、复发性热性惊厥且脑电图有癫痫样波形的患者中有31%发生了癫痫发作。癫痫样放电的阳性预测价值在复杂性热性惊厥中较低,在复发性热性惊厥中则高出两倍。

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