Xu Y, Dong X R, Zhang P, Wang X H, Zhou Y F, Cheng G Q
Department of Neurology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China.
Molecular Genetic Diagnosis Center, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China.
Zhonghua Er Ke Za Zhi. 2021 Dec 2;59(12):1055-1058. doi: 10.3760/cma.j.cn112140-20210324-00252.
To investigate the phenomenon of epileptic spasms (ES) and focal seizures (FS) in a single ictal event (FS-ES phenomenon) and to study the etiology, manifestations, and prognosis of this phenomenon. The data of the 15 neonates who had ES and FS in a single ictal event, according to video-electroencephalography (VEEG) recording in Department of Neonatology of Children's Hospital of Fudan University during the period of January 2018 to December 2019, was analyzed retrospectively. Of the 15 neonates, 7 were male and 8 were female. Gestational age was 39 (32-42) weeks. Birth weight was 3 100 (1 825-3 850) g. The initial onset age of convulsions was 2 (1-10) days. The age of the first discovery of FS-ES phenomenon was 25 (14-32) days. The age of seizure-free was 7(1-27) months. All of the initial seizure types were FS. The FS-ES phenomenon of 15 patients started with FS. The FS-ES phenomenon manifested in 2 forms: FS followed by ES (12 cases), ES appeared during an FS without interrupting FS (2 cases). In 1 neonate the spasm occurred in both forms. The etiology included genetic factors (9 cases), intracranial infection (1 case), abnormal brain tissue structure (2 cases), and etiology was unknown in 3 cases. All the neonates had a poor prognosis except one. The FS-ES phenomenon in the neonatal period starts with FS. There are various etiologies. Etiologies of most patients are genetic factors. Most of the patients have a poor prognosis.
探讨单次发作事件中癫痫性痉挛（ES）与局灶性发作（FS）并存的现象（FS-ES现象），并研究该现象的病因、临床表现及预后。回顾性分析2018年1月至2019年12月复旦大学附属儿科医院新生儿科通过视频脑电图（VEEG）记录的15例单次发作事件中出现ES和FS的新生儿资料。15例新生儿中，男7例，女8例。胎龄为39（32 - 42）周。出生体重为3100（1825 - 3850）g。惊厥初发年龄为2（1 - 10）天。首次发现FS-ES现象的年龄为25（14 - 32）天。无发作年龄为7（1 - 27）个月。所有初发发作类型均为FS。15例患者的FS-ES现象均以FS起病。FS-ES现象表现为2种形式：FS后出现ES（12例），ES在FS期间出现且未中断FS（2例）。1例新生儿两种形式均有痉挛发作。病因包括遗传因素（9例）、颅内感染（1例）、脑组织结构异常（2例），3例病因不明。除1例患者外，所有新生儿预后均较差。新生儿期的FS-ES现象以FS起病，病因多样，多数患者病因是遗传因素，多数患者预后较差。
