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先天性寨卡综合征 36 个月以下儿童耐药性癫痫的相关特征。

Characteristics associated with drug resistant epilepsy in children up to 36 months old with Congenital Zika Syndrome.

机构信息

Department of Public Health, Programa de Pós-Graduação em Saúde Coletiva, Federal University of Maranhão, Rua Barão de Itapary, 155, Centro, São Luís, Maranhão 65020- 070, Brazil.

Department of Medicine III. Federal University of Maranhão, São Luís, Maranhão, Brazil.

出版信息

Seizure. 2022 Dec;103:92-98. doi: 10.1016/j.seizure.2022.11.001. Epub 2022 Nov 4.

Abstract

OBJECTIVES

To verify characteristics associated with drug resistant epilepsy in children up to 36 months of age with Congenital Zika Syndrome (CZS).

METHODS

This is a prospective cohort study with children aged up to 36 months diagnosed with CZS. Obstetric, demographic, phenotype and other clinical signs, cranial tomography, growth and motor development of the children were collected.

RESULTS

Of a total of 109 children diagnosed with CZS, 100 (91.7%) had epilepsy and 68 (68%) with drug resistant seizures. The types of seizures associated with drug resistant epilepsy were focal seizures from the occipital lobe, generalized tonic and generalized tonic-clonic seizures. There was an association between drug resistant epilepsy and microcephaly at birth, severe microcephaly at birth, excess nuchal skin, ventriculomegaly, reduced brain parenchyma volume, and hypoplasia or malformation of the cerebellum. Difficulty sleeping, irritability, continuous crying, dysphagia and gross motor function were clinical signs associated with drug resistant epilepsy, as were the presence of ocular abnormalities, low head circumference in the first year of life and low weight in the first six months.

CONCLUSIONS

The prevalence of drug resistant epilepsy in children up to 36 months with CZS was 62.4% and was associated with the severity of the child's neurological damage, with emphasis on the reduction of brain parenchyma volume and damage to the cerebellum.

摘要

目的

验证与 36 个月以下先天性寨卡综合征(CZS)儿童耐药性癫痫相关的特征。

方法

这是一项前瞻性队列研究,纳入了 36 个月以下被诊断为 CZS 的儿童。收集了儿童的产科、人口统计学、表型和其他临床体征、头颅 CT、生长和运动发育情况。

结果

在总共 109 名被诊断为 CZS 的儿童中,100 名(91.7%)患有癫痫,68 名(68%)癫痫发作耐药。耐药性癫痫相关的癫痫发作类型为枕叶局灶性发作、全面强直阵挛发作。耐药性癫痫与出生时的小头畸形、出生时严重的小头畸形、多余的颈部皮肤、脑室扩大、脑实质体积减少以及小脑发育不良或畸形有关。睡眠困难、易激惹、持续哭闹、吞咽困难和粗大运动功能障碍是与耐药性癫痫相关的临床特征,还包括眼部异常、生命第一年头围较小和生命最初 6 个月体重较轻。

结论

36 个月以下 CZS 儿童耐药性癫痫的患病率为 62.4%,与儿童神经损伤的严重程度相关,强调脑实质体积减少和小脑损伤。

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