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[儿童中线棘波的临床与脑电图评估]

[Clinical and EEG evaluation of mid-line spikes in childhood].

作者信息

Konishi T, Naganuma Y, Hongou K, Murakami M, Yamatani M, Okada T

机构信息

Department of Pediatrics, Faculty of Medicine, Toyama Medical and Pharmaceutical University, Japan.

出版信息

No To Shinkei. 1988 Dec;40(12):1189-93.

PMID:3248196
Abstract

We studied the clinical and electroencephalographic (EEG) characteristics of 45 patients with mid-line spikes. The incidence of mid-line spikes was 3.0% in total EEG population in childhood. Sex incidence was equal. First appearance age of mid-line spikes ranged from one month to 12 years, with a mean of 5.0 years old. Fz focus was in 3 patients, Cz in 31 and Pz in 11. Thirty two of the 45 patients (71%) had a history of clinical seizures; 16 with febrile convulsions and 16 with epileptic seizures. Of the remaining 13 patients without a history of seizures, the EEG was obtained because of post-meningitis in 4, developmental delayed in 4, migraine in 1 and miscellaneous in 4. Mid-line spikes might not have so strong correlations with clinical seizures. Ten patients had a family history of epilepsy and/or febrile convulsion. In the patients with seizures, generalized tonic-clonic seizures were the most frequent type (18; primary GTC and 10; secondary GTC with partial onset). Elementary symptoms of partial seizures were very variable (focal motor in 5, Jacksonian march in 1, aversive in 1, autonomic in 2 and automatism in 5), and which might be related to the other lesions such as temporal and/or frontal lobes. Seizure control was almost good except for two patients with organic brain damage. And other neurological symptoms were not also progressive. On EEG findings, twenty-two patients had midline spikes as their only epileptiform abnormality. The remaining twenty-three had an additional epileptiform feature, either a focal spikes or a generalized spike-wave.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

我们研究了45例中线棘波患者的临床和脑电图(EEG)特征。儿童EEG总体人群中中线棘波的发生率为3.0%。男女发生率相等。中线棘波首次出现的年龄范围为1个月至12岁,平均为5.0岁。Fz导联有3例,Cz导联有31例,Pz导联有11例。45例患者中有32例(71%)有临床癫痫发作史;16例有热性惊厥,16例有癫痫发作。其余13例无癫痫发作史的患者中,4例因脑膜炎后、4例因发育迟缓、1例因偏头痛、4例因其他杂症进行了EEG检查。中线棘波与临床癫痫发作可能没有那么强的相关性。10例患者有癫痫和/或热性惊厥家族史。在有癫痫发作的患者中,全身性强直阵挛发作是最常见的类型(18例;原发性GTC和10例;继发性GTC伴部分性发作)。部分性发作的基本症状变化很大(5例为局灶性运动性发作、1例为杰克逊癫痫、1例为厌恶发作、2例为自主神经性发作、5例为自动症),这可能与颞叶和/或额叶等其他病变有关。除2例有器质性脑损伤的患者外,癫痫发作控制情况几乎良好。其他神经症状也没有进展。在EEG检查结果中,22例患者的中线棘波是其唯一的癫痫样异常。其余23例有额外的癫痫样特征,要么是局灶性棘波,要么是全身性棘慢波。(摘要截断于250字)

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