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[儿童失神癫痫的治疗效果与治疗抵抗]

[Treatment result and treatment resistance in early childhood petit mal epilepsy].

作者信息

Tatzer E, Groh C, Rosenmayr F W

出版信息

Padiatr Padol. 1981;16(3):343-51.

PMID:6789288
Abstract

The data of 115 children with age-dependent epilepsy in early childhood and treated in the out-patient department of the university clinic for pediatrics in Vienna in the past 20 years were prepared for computerization and subsequently processed. The average observation period was 10,9 years (SD = 6,81 years). At the time of the study 20 out of 35 children with infantile spasms and 61 out of 80 children with myoclonic-astatic seizures were free from seizures. We consider Benzidiazepines to be the optimum treatment for both of the above-mentioned kinds of seizures. If they failed to achieve the desired success, ACTH and steroids proved to be quite effective. In cases of myoclonicastatic seizures with generalized EEG patterns, VPA is indicated. In order to be able to judge the dynamics in psychic development more effectively, we divided our patients into three groups: children with stable development, those with obvious retardation, and those with obvious positive development in the course of therapy. There was no statistically significant correlation between a delayed onset of therapy and the absence of seizures as well as a more satisfactory psychic development (according to the Man-Whitney-Test and the Kruskal-Wallis-Test). In children with infantile spasms we found a statistically significant correlation (p less than 0.05) between relief from seizures and a satisfactory psychic development. In general, the somatic and psychic prognosis of Petit-Mal epilepsies in early childhood seems to depend on pretherapeutical factors.

摘要

整理了过去20年在维也纳大学儿科门诊治疗的115例幼儿期年龄相关性癫痫患儿的数据,准备进行计算机化处理并随后进行分析。平均观察期为10.9年(标准差=6.81年)。在研究时,35例婴儿痉挛症患儿中有20例、80例肌阵挛-无动性发作患儿中有61例无癫痫发作。我们认为苯二氮䓬类药物是上述两种癫痫发作的最佳治疗方法。如果未能取得预期效果,促肾上腺皮质激素和类固醇被证明相当有效。对于脑电图呈现广泛性模式的肌阵挛-无动性发作病例,建议使用丙戊酸。为了能够更有效地判断心理发展的动态变化,我们将患者分为三组:发育稳定的儿童、明显发育迟缓的儿童以及在治疗过程中明显有积极发展的儿童。治疗开始延迟与无癫痫发作以及更令人满意的心理发展之间没有统计学上的显著相关性(根据曼-惠特尼检验和克鲁斯卡尔-沃利斯检验)。在婴儿痉挛症患儿中,我们发现癫痫发作缓解与令人满意的心理发展之间存在统计学上的显著相关性(p<0.05)。一般来说,幼儿期小发作癫痫的躯体和心理预后似乎取决于治疗前的因素。

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