Lagenstein I, Iffland E
EEG EMG Z Elektroenzephalogr Elektromyogr Verwandte Geb. 1977 Jun;8(2):82-8.
Interrupting petit-mal status in infantile myoclonic seizures (n = 11), Lennox syndrom (n = 32), and in myoclonicastatic petit mal (n = 13) diazepame (Valium) and clonazepame (Rivotril) have been injected intraveneously in 56 patients during continuous EEG monitoring (38 patients with diazepame, 18 patients with clonazepame) (Table 1). A judgement according to the EEG findings and the apparent vigilance was performed thirty minutes after the injection was completed (Fig. 1 und 2; Table 3). Following results are presented: 1) There are no significant differences between clonazepame and diazepame with respect to therapeutic success (Table 3). 2. There are almost no differences concerning therapeutic success in the three forms of petit-mal status listed above (Table 3). 3) The initial success was 57%: 46% in infantile myoclonic seizures, 56% in Lennox syndrome, 70% in myoclonic-astatic petit-mal. The number of relapses for all forms was high: On the day following the injection only 18% of all patients did not show continued petit-mal-status: 18% in infantile myoclonic seizures, 15% in Lennox syndrome, 23% in myoclonicastatic petit mal (Table 3). 4) 13 patients were no longer in a status on the following day. 3 children were out of status spontaneously, independent from the intravenous application, 4 patients, one with infantile myoclonic seizures and 3 with Lennox syndrome, showed a focal EEG, 6 patients, 2 with infantile myoclonic seizures, 3 with Lennox syndrome, 4 with myoclonic-astatic petit mal, were further demonstrating generalised paroxysms (Fig. 1 und 2). 5) In infantile myoclonic seizures and in the Lennox syndrome almost always a focal EEG could be seen that accompanied the decrease of generalised paroxysms (hypsarrhythmia or 2/sec slow wave and spike). This finding has not been seen in the myoclonic-astatic petit mal, another sign that the latter is of primary generalised, "centrencephal" origin in contrast to the first two forms of convulsive disorders (Fig. 1, 2).
在婴儿肌阵挛性癫痫(n = 11)、Lennox综合征(n = 32)和肌阵挛 - 静止性小发作(n = 13)的小发作状态中断时,在持续脑电图监测期间,已对56例患者静脉注射地西泮(安定)和氯硝西泮(利必通)(38例注射地西泮,18例注射氯硝西泮)(表1)。注射完成30分钟后,根据脑电图结果和明显的警觉性进行判断(图1和2;表3)。呈现以下结果:1)氯硝西泮和地西泮在治疗成功率方面无显著差异(表3)。2. 上述三种小发作状态形式在治疗成功率方面几乎没有差异(表3)。3)初始成功率为57%:婴儿肌阵挛性癫痫为46%,Lennox综合征为56%,肌阵挛 - 静止性小发作为70%。所有形式的复发率都很高:注射后的第二天,只有18%的患者未出现持续的小发作状态:婴儿肌阵挛性癫痫为18%,Lennox综合征为15%,肌阵挛 - 静止性小发作为23%(表3)。4)13例患者在第二天不再处于发作状态。3名儿童自发停止发作,与静脉注射无关,4例患者,1例婴儿肌阵挛性癫痫和3例Lennox综合征患者,脑电图显示局灶性改变,6例患者,2例婴儿肌阵挛性癫痫、3例Lennox综合征、4例肌阵挛 - 静止性小发作患者,进一步显示全身性发作(图1和2)。5)在婴儿肌阵挛性癫痫和Lennox综合征中,几乎总是可以看到随着全身性发作(高度节律失调或每秒2次慢波和棘波)减少而出现的局灶性脑电图。在肌阵挛 - 静止性小发作中未见到这一发现,这是另一个迹象,表明与前两种惊厥性疾病形式相比,后者起源于原发性全身性“中央脑”(图1、2)。