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脑瘫患儿难治性癫痫的危险因素

Risk Factors of Intractable Epilepsy in Children with Cerebral Palsy.

作者信息

Abdel Maksoud Yehia Hamed, Suliman Hany Abdelaziz, ElSAYED Abdulsamea Sameh, Mohamed Kamal Naglaa, Al-Shokray Ashraf Hamed, Ibrahim Asmaa Obada, Elshorbagy Hatem Hamed, Fathallah Mohamed Gamal El Din, Attia Ahmed Mahmoud, Elsadek Akram Elshafey

机构信息

Pediatric department, Benha University, Benha, Egypt.

Pediatric department, Faculty of medicine, Cairo University, Cairo, Egypt.

出版信息

Iran J Child Neurol. 2021 Fall;15(4):75-87. doi: 10.22037/ijcn.v15i3.31556.

Abstract

OBJECTIVES

We aimed to investigate the risk factors predicting the development of intractable epilepsy in children with cerebral palsy (CP), with an emphasis on perinatal characteristics, seizure semiology, imaging, and EEG findings.

MATERIALS & METHODS: Following a descriptive, retrospective, case-control design, 106 children with CP and epilepsy from 2015 to 2020 were studied (46 children with CP and intractable epilepsy and 60 with CP and controlled epilepsy). Data were retrieved from medical records of participants (i.e., demographics, clinical characteristics, perinatal history, etiology of seizure and CP, seizure semiology, intellectual functions, therapeutic options, brain imaging, and EEG findings).

RESULTS

We established a model of the most important risk factors that can predict intractable epilepsy in children with CP. The model included the additive effect of a poor Apgar score at 5 minutes, the presence of neonatal seizures, focal epilepsy, and focal slowing on the EEG background (Area under the receiver operating characteristic of 0.810).

CONCLUSION

The findings can be used to identify intractable epilepsy in children who suffer from CP with further support by offering early therapeutic interventions intended to reduce the burden of refractory seizures.

摘要

目的

我们旨在调查预测脑瘫(CP)患儿难治性癫痫发生的危险因素,重点关注围产期特征、癫痫发作症状学、影像学和脑电图结果。

材料与方法

采用描述性、回顾性病例对照设计,对2015年至2020年期间的106例患有CP和癫痫的儿童进行研究(46例患有CP和难治性癫痫的儿童以及60例患有CP和可控性癫痫的儿童)。从参与者的医疗记录中检索数据(即人口统计学、临床特征、围产期病史、癫痫发作和CP的病因、癫痫发作症状学、智力功能、治疗选择、脑成像和脑电图结果)。

结果

我们建立了一个可预测CP患儿难治性癫痫的最重要危险因素模型。该模型包括5分钟时阿氏评分低、新生儿癫痫发作、局灶性癫痫以及脑电图背景上的局灶性慢波的累加效应(受试者操作特征曲线下面积为0.810)。

结论

这些发现可用于识别患有CP的儿童中的难治性癫痫,并通过提供旨在减轻难治性癫痫发作负担的早期治疗干预措施来提供进一步支持。

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