Pietz J, Benninger C, Schmidt H, Scheffner D, Bickel H
Universitäts-Kinderklinik, Neuropädiatrische Abteilung, Heidelberg, Federal Republic of Germany.
Eur J Pediatr. 1988 May;147(4):361-7. doi: 10.1007/BF00496411.
In 34 children with phenylketonuria (PKU) treated early the prognostic value of the age on institution of the diet (within the first 3 months of life) and of the quality of dietary treatment was determined in two different ways: 1) following intelligence closely (IQ) and (2) evaluating the EEG development up to their 12th (n = 34) and 15th (n = 18) years of life as appropriate. In general, IQ scores were found to be normal from the 4th-15th years of life. In our group of patients there was no effect on the IQ of the timing of diet onset. Children with "strict" dietary control showed a significantly higher IQ than those with "loose" control. One hundred and fifty-four EEGs (10/20 system, awake with eyes closed) were recorded at intervals of 2 years and conventionally evaluated. The development of alpha-activity was found to be normal. Beta-activity was enhanced. Abnormal EEG findings like general slowing and generalized paroxysmal activity (GPA) with or without spikes were more frequent in children with PKU than in controls, with the exception of focal abnormalities. EEG abnormalities increased with advancing age independently of IQ development and showed no relation to either the age at the onset nor the quality of dietary treatment.
在34例早期接受治疗的苯丙酮尿症(PKU)患儿中,通过两种不同方式确定了开始饮食治疗时的年龄(出生后前3个月内)及饮食治疗质量的预后价值:1)密切跟踪智力(智商);2)在患儿12岁(n = 34)及15岁(n = 18)时酌情评估脑电图发育情况。总体而言,4至15岁时智商得分正常。在我们的患者组中,开始饮食治疗的时间对智商没有影响。饮食控制“严格”的患儿智商显著高于“宽松”控制的患儿。每隔2年记录154次脑电图(10/20系统,闭眼清醒状态)并进行常规评估。发现α波活动发育正常。β波活动增强。除局灶性异常外,苯丙酮尿症患儿中出现如普遍减慢和伴有或不伴有棘波的全身性阵发性活动(GPA)等异常脑电图表现比对照组更常见。脑电图异常随年龄增长而增加,与智商发育无关,且与开始治疗的年龄及饮食治疗质量均无关联。