Cusmai R, Dulac O, Diebler C
Service de neuropédiatrie, INSERM U-29, Hôpital Saint-Vincent-de-Paul, Paris, France.
Neurophysiol Clin. 1988 Jun;18(3):235-41. doi: 10.1016/s0987-7053(88)80028-5.
Among 174 cases of infantile spasms examined by CT-scan between January 80 and December 85, 17 (9.8%) had a focal lesion without microcephaly. It consisted of an angioma (1 case), a cortical dysplasia (1 case) and porencephalic lesions (15 cases). In 11 cases with porencephaly, an acute event had occurred between 28 weeks of gestation and 3 months of life. In 7 cases, the lesion extended to the major part of one hemisphere. In the 10 others, it was localized either to the rolandic or to the temporo-occipital regions. In all the cases, the lesion concerned at least one of these areas. It involved the cortex in 15 cases but in the 2 others it seemed to only concern the white matter. The lesion was on the left in 14 cases. After steroids, the epilepsy recurred in 6 cases of which 5 involved the frontal lobe (P less than 0.05). This study seems to show that it is mainly the rolandic and the temporo-occipital areas that favour the occurrence of infantile spasms, whereas extension to the frontal area is responsible of a later partial epilepsy.
在1980年1月至1985年12月期间接受CT扫描检查的174例婴儿痉挛症病例中，17例（9.8%）有局灶性病变但无小头畸形。病变包括1例血管瘤、1例皮质发育异常和15例脑穿通畸形。在11例脑穿通畸形病例中，在妊娠28周和出生后3个月之间发生了急性事件。7例中，病变扩展至一个半球的大部分。在其他10例中，病变局限于中央沟或颞枕区域。在所有病例中，病变至少累及这些区域之一。15例累及皮质，但另外2例似乎仅累及白质。14例病变位于左侧。使用类固醇后，6例癫痫复发，其中5例累及额叶（P<0.05）。这项研究似乎表明，主要是中央沟和颞枕区域易发生婴儿痉挛症，而扩展至额叶则导致后期的部分性癫痫。
