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[癫痫的电临床及发育形式与其在生命不同年龄段出现情况的关系]

[Electro-clinical and developmental forms of epilepsy as a function of their appearance at different ages of life].

作者信息

Gastaut H, Oller-Daurella L

出版信息

Acta Neurol Latinoam. 1981;27(1-2):19-50.

PMID:6965168
Abstract

The authors review the different electroclinical varieties and the evolution of epilepsy that appear in the six principal age groups: newborn, infancy, childhood, adolescence, adult and aged. The aim of this study is to answer the following questions: on one hand to find out if there exists in newborn, infant or young child, a form of epilepsy entirely functional, dependent on a constitutional epileptic predisposition transmitted on a genetic basis, which correspond to the primary generalized epilepsy of the other age groups. If that is so, to find out this mode of expression. On the other hand, to confirm whether the proportion of primary generalized epilepsy varies according to the different ages of life, revealing a chance in the predisposition during life. The authors propose the following answers to the above-mentioned questions: there exists at birth a principally, functional form of epilepsy in relation to a constitutional predisposition. The usual electroclinical criteria are not applicable in this age group due to brain immadurity, so it is not possible to identify this variety. The progressive development of the brain in the infant and young child permits the clinical and electrical individualization of generalized fits as distinct from Petit or Gran Mal. These facts make it possible to confirm the existence of a principally functional epilepsy which corresponds to the primary generalized epilepsy of the adolescent and older child. The epileptic predisposition, principal factor responsible for primary generalized epilepsy, varies considerably during life. The authors presume that its incidence differs in each age group. Based on the frequency of hyperthermic fits in the infant and young child, the predisposition should be important in this age group, although the actual proportion of primary generalized epilepsy is difficult to quantify. In the older child it is possible to admit that the epileptic predisposition is greater because primary generalized epilepsy represents more than a third of the types of fits observed. This tendence is even greater in adolescence, where this form of epilepsy represents over three quarters of the patients. In the adult and aged patients, the epileptic tendency diminishes progressively, as can be seen comparing the proportion of primary forms of epilepsy with other types (25% young adult, 9% mature adult and 1% in the aged).(ABSTRACT TRUNCATED AT 400 WORDS)

摘要

作者回顾了癫痫在六个主要年龄组(新生儿、婴儿期、儿童期、青春期、成年期和老年期)出现的不同电临床类型及其演变。本研究的目的是回答以下问题:一方面,要查明在新生儿、婴儿或幼儿中,是否存在一种完全功能性的癫痫形式,它依赖于基于遗传传递的体质性癫痫易感性,这与其他年龄组的原发性全身性癫痫相对应。如果是这样,要找出这种表达方式。另一方面,要确认原发性全身性癫痫的比例是否因生命的不同年龄而有所变化,揭示出一生中易感性的变化。作者对上述问题提出了以下答案:出生时存在一种主要与体质性易感性相关的功能性癫痫形式。由于大脑不成熟,通常的电临床标准不适用于这个年龄组,因此无法识别这种类型。婴幼儿大脑的逐步发育使全身性发作在临床和电方面能够与小发作或大发作区分开来进行个体化。这些事实使得能够确认存在一种主要功能性的癫痫,它与青少年和大龄儿童的原发性全身性癫痫相对应。癫痫易感性是原发性全身性癫痫的主要成因,在一生中变化很大。作者推测其发病率在每个年龄组中都不同。基于婴幼儿高热惊厥的频率,虽然原发性全身性癫痫的实际比例难以量化,但在这个年龄组中易感性应该很重要。在大龄儿童中,可以认为癫痫易感性更高,因为原发性全身性癫痫占所观察到的发作类型的三分之一以上。在青春期这种趋势更为明显,这种癫痫形式占患者的四分之三以上。在成年和老年患者中,癫痫倾向逐渐减弱,从原发性癫痫形式与其他类型的比例比较中可以看出(青年成人中占25%,成熟成人中占9%,老年人中占1%)。(摘要截选至400字)

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