Shuper A, Mimouni M
Children's Medical Centre of Israel, Petah Tiqva, Israel.
Arch Dis Child. 1995 Oct;73(4):342-4. doi: 10.1136/adc.73.4.342.
Twenty two babies under 1 year old were referred for evaluation of suspected epileptic seizures. Nine were found to have epilepsy. In the other 13--all developing normally, aged up to 10 months--the spells were non-epileptic paroxysmal events (NEPE). They consisted of five patterns of movement: (1) eye blinking; (2) 'no' movements; (3) body posturing with head and arm jerks; (4) masturbation-like movements; and (5) myoclonic head flexion. The NEPE were present for a period of two weeks to seven months. Although some NEPE cannot be clinically differentiated from true epilepsy, in these infants at least four interictal EEGs were normal, the spells completely resolved after a relatively short period without antiepileptic treatment, and the infants continued to develop normally with no evidence of epilepsy during a follow up period of 28 to 38 months. This sample indicates that the frequency of NEPE in the first year of life may be high. Cautious clinical consideration, repeat EEGs and, when appropriate, a few weeks' observation are recommended. Awareness of these benign behavioural spells in this young age group is important, and parents can be reassured. Nevertheless, the spells may illustrate a 'foggy frontier' between NEPE and epilepsy. The lack of evidence for any other disease process in affected infants, as well as the disappearance of the NEPE without any intervention, indicates that a maturational process may be involved.
22名1岁以下的婴儿因疑似癫痫发作被转诊进行评估。其中9名被诊断患有癫痫。另外13名婴儿——均发育正常，年龄最大为10个月——其发作属于非癫痫性阵发性事件（NEPE）。这些发作包括五种运动模式：（1）眨眼；（2）“摇头”动作；（3）身体姿势伴头部和手臂抽搐；（4）类似自慰的动作；（5）肌阵挛性头部前屈。NEPE持续时间为两周至七个月。尽管有些NEPE在临床上无法与真正癫痫相区分，但在这些婴儿中，至少4次发作间期脑电图正常，发作在相对较短时间内完全缓解，未接受抗癫痫治疗，且在28至38个月的随访期内婴儿继续正常发育，无癫痫证据。该样本表明，1岁以内婴儿中NEPE的发生率可能较高。建议进行谨慎的临床评估、重复脑电图检查，并在适当情况下进行几周的观察。认识到这个年龄组中这些良性行为发作很重要，可以让家长放心。然而，这些发作可能说明了NEPE和癫痫之间的“模糊界限”。受影响婴儿缺乏任何其他疾病过程的证据，以及NEPE未经任何干预即消失，表明可能涉及一个成熟过程。
