Panayiotopoulos C P
Division of Neurology and Clinical Neurophysiology, King Khalid University Hospital, Riyadh, Saudi Arabia.
J Neurol Neurosurg Psychiatry. 1988 Nov;51(11):1448-51. doi: 10.1136/jnnp.51.11.1448.
Twenty-four out of 900 adult and children patients with epilepsy, were found to have vomiting during an ictus. All the 24 patients were children before puberty with a similar clinical pattern consisting of partial seizures which were mainly nocturnal. Ictal vomiting was always concurrent with other epileptic manifestations, more often deviation of the eyes and impairment of consciousness. The initial part of the ictus was short or prolonged for hours with frequent "marching" to hemi-convulsions and generalised seizures. Seventeen of the 24 children suffered from benign childhood epilepsies (BCE) with complete remission in long follow-up. A significantly higher association was found between ictal vomiting and the syndrome of BCE with occipital spikes (p less than 0.001) but not with centro-temporal spikes (p less than 0.2). The recognition of this association may have important theoretical implications. On clinical grounds, it may prevent unnecessary investigations and undue concern.
在900例成年和儿童癫痫患者中，有24例在发作期间出现呕吐。这24例患者均为青春期前儿童，具有相似的临床模式，主要为部分性发作，且多在夜间发作。发作期呕吐总是与其他癫痫表现同时出现，更常见的是眼球偏斜和意识障碍。发作初期短暂或持续数小时，常频繁“进展”为半侧惊厥和全身性发作。24例儿童中有17例患有儿童良性癫痫（BCE），长期随访后完全缓解。发现发作期呕吐与伴有枕叶棘波的BCE综合征之间存在显著更高的关联（p<0.001），但与中央颞区棘波无关联（p<0.2）。认识到这种关联可能具有重要的理论意义。从临床角度看，它可能避免不必要的检查和过度担忧。
