Koo B, Hwang P A, Logan W J
Department of Paediatrics, Hospital for Sick Children, Toronto, ON, Canada.
Neurology. 1993 Nov;43(11):2322-7. doi: 10.1212/wnl.43.11.2322.
We reviewed the outcome (developmental, neurologic, and seizure) and prognostic factors of 57 cases of infantile spasms (17 cryptogenic, 40 symptomatic). The mean developmental score of the cryptogenic group (71.2 +/- 24.2) was significantly higher than that of the symptomatic group (48.4 +/- 24.5), as assessed by the Griffith Mental Developmental Scale. A resultant neurologic deficit was present in 23.5% of the cryptogenic group and 75.0% of the symptomatic group. Coexistence of other forms of seizures was observed in 35.3% of the cryptogenic group and 57.5% of the symptomatic group. Outcome was affected by the coexistence of other seizures, presence of neurologic deficit, time lag in initiation of treatment (cognitive outcome only), poor response to ACTH treatment, and persistent EEG abnormality. Character of spasms and time lag in initiation of treatment (seizure outcome only) did not have any significant effect on outcome.
我们回顾了57例婴儿痉挛症(17例隐源性、40例症状性)的预后(发育、神经和癫痫发作情况)及预后因素。根据格里菲斯心理发育量表评估,隐源性组的平均发育得分(71.2±24.2)显著高于症状性组(48.4±24.5)。隐源性组23.5%出现神经功能缺损,症状性组为75.0%。隐源性组35.3%、症状性组57.5%观察到存在其他形式的癫痫发作。预后受其他癫痫发作的并存、神经功能缺损的存在、治疗开始的时间延迟(仅认知预后)、对促肾上腺皮质激素(ACTH)治疗反应不佳以及脑电图持续异常的影响。痉挛特征和治疗开始的时间延迟(仅癫痫发作预后)对预后无显著影响。