Laubichler W, Plöchl E
Wien Klin Wochenschr. 1975 Aug 15;87(15):475-80.
Between 3700 and 3900 children are admitted annually to this children's hospital. During the past four years a total of 455 children with convulsions were admitted for investigation. 255 of these cases were calcified as epilepsy, 202 as febrile convulsions and 28 as neonatal convulsions. A quarter of the epileptic children showed fits of the petit mal type. There were only 5 cases of infantile propulsive petit mal. High frequency of fits and, in particular, status epilepticus, were very rarely seen in the present study. A case of self-induced photosensitive epilepsy, later combined with psychomotor epilepsy, is referred to in detail. Of 149 children with grand mal epilepsy, 36 were classed as idiopathic, and 88 as symptomatic cases. 37 of the symptomatic cases showed focal epilepsy with generalisation. It was concluded from the clinical course and the EEG that the combined effects of familial predisposition towards fits and exogenous cerebral lesions were operative factors in 14 patients. Children with febrile, convulsions possessed an EEG suggestive of a familial predisposition towards fits in slightly more than 50% of the cases. No cause could be found for the seizures in 5 infants with neonatal convulsions, but the mother of one of these infants was an epileptic herself, undergoing treatment with anticonvulsive drugs in high dosage and a withdrawal syndrome was suspected in this particular case. 17 infants with neonatal convulsions were symptomless on leaving hospital and remained so during the first year of life. Of the remaining cases, 10 showed neurological disturbances and one died. There was only one case in which neonatal convulsions progressed directly to epilepsy. The peak incidence of the first appearance of fits occurred during the first year of life (136 children), with 18% of the entire case material presenting within the first 6 months. 108 children presented with fits for the first time during the second year of life. Thereafter, the tendency towards the development of fits for the first time in life declined with increasing age.
这家儿童医院每年收治3700至3900名儿童。在过去四年中，共有455名惊厥儿童入院接受检查。其中255例被确诊为癫痫，202例为高热惊厥，28例为新生儿惊厥。四分之一的癫痫儿童表现为小发作类型。婴儿推进性小发作仅有5例。在本研究中，惊厥发作频率高，尤其是癫痫持续状态，非常罕见。详细介绍了一例自我诱发的光敏性癫痫病例，该病例后来合并为精神运动性癫痫。在149例大发作癫痫儿童中，36例为特发性，88例为症状性病例。37例症状性病例表现为局灶性癫痫伴泛化。从临床病程和脑电图得出的结论是，家族性惊厥易感性和外源性脑损伤的综合作用是14例患者的发病因素。超过50%的高热惊厥儿童脑电图显示有家族性惊厥易感性。5例新生儿惊厥婴儿未发现惊厥原因，但其中一名婴儿的母亲本身就是癫痫患者，正在接受高剂量抗惊厥药物治疗，怀疑该病例存在戒断综合征。17例新生儿惊厥婴儿出院时无症状，在生命的第一年一直如此。其余病例中，10例出现神经功能障碍，1例死亡。只有1例新生儿惊厥直接发展为癫痫。惊厥首次出现的高峰发病率出现在生命的第一年（136名儿童），18%的全部病例在头6个月内出现。108名儿童在生命的第二年首次出现惊厥。此后，随着年龄增长，首次出现惊厥的趋势下降。
