Korinthenberg R, Palm D
Klin Padiatr. 1980 Mar;192(2):142-9. doi: 10.1055/s-2008-1033873.
55 children suffering from acute lymphoblastic leukemia were treated wih prednisone, vincristin-sulfate, daunorubicine and L-asparaginase (1st month), 6-mercapto-purine, cytosine-arabinoside. cyclophospamide, methotrexate-i.th. and cranial irradiation (2nd month). Maintenance-therapy comprised 6-mercapto-purine, cyclophosphamide and methotrexate-i.v. Serial EEG-examination were done in most of them during the course of treatment. 4 children presented with meningeal leukemia at the time of diagnosis. Their EEGs showed moderate slowing before treatment and at the end of the first month. One of them suffered a focal convulsion two days after the last VCR/daunorubine-injection. All EEG-changes were completely reversible later on. 3 patients showed severe focal EEG-disturbances and convulsions during serious neurological complications (intracranial bleeding, rubella-encephalitis). The remaining patients were free of complications at the time of the EEG-examination. Before therapy 24% of them presented normal findings, 57% slightly and 19% moderately abnormal EEGs. At the end of the first month there was an increase of moderate and severe EEG-slowing to 37% and 23%, only 11% of findings were normal. Improvement during the second month of therapy led to 37% normal and 57% slightly abnormal EEG-findings at its end. After maintenance-therapy of 1/2--1 year duration there were 65% normal EEGs and no moderate and severe disturbances any longer. Quantitative spectral analysis of the EEG in 6 additional children revealed similar changes.
55名急性淋巴细胞白血病患儿接受了泼尼松、硫酸长春新碱、柔红霉素和L-天冬酰胺酶(第1个月)、6-巯基嘌呤、阿糖胞苷、环磷酰胺、鞘内注射甲氨蝶呤及头颅照射(第2个月)治疗。维持治疗包括静脉注射6-巯基嘌呤、环磷酰胺和甲氨蝶呤。大多数患儿在治疗过程中进行了系列脑电图检查。4名患儿在诊断时出现脑膜白血病。他们的脑电图在治疗前和第1个月末显示中度减慢。其中1名患儿在最后一次长春新碱/柔红霉素注射后两天发生局灶性惊厥。所有脑电图改变后来均完全可逆。3例患者在严重神经并发症(颅内出血、风疹性脑炎)期间出现严重局灶性脑电图紊乱和惊厥。其余患儿在进行脑电图检查时无并发症。治疗前,24%的患儿脑电图结果正常,57%轻度异常,19%中度异常。在第1个月末,中度和重度脑电图减慢分别增加到37%和23%,只有11%的结果正常。治疗第2个月病情改善,月末脑电图结果37%正常,57%轻度异常。在进行了为期半年至1年的维持治疗后,65%的患儿脑电图正常,不再有中度和重度紊乱。另外6名患儿的脑电图定量频谱分析显示了类似的变化。