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儿童癫痫:其发作形式与病程的鉴别诊断(作者译)

[Epilepsies in childhood: differential diagnosis of their forms and courses (author's transl)].

作者信息

Niedermeyer E

出版信息

EEG EMG Z Elektroenzephalogr Elektromyogr Verwandte Geb. 1976 Mar;7(1):21-33.

PMID:829045
Abstract

Childhood epilepsies (not including the first 2 years of life) are outlined and discussed; particular emphasis is laid upon the variety of certain forms of epileptic conditions and their clinical course. These forms are divided as follows: a) The Lennox-Gastaut syndrome: a poly-etiological condition with distinct clinical-ictal and electroencephalographic characteristics, mostly associated with mental defects and prognostically unfavorable. b) "Common generalized epilepsy" (also called "centrencephalic" epilepsy), characterized by petit mal absences or a combination of petit mal and grand mal and with a predominantly favorable prognosis. c)Childhood epilepsies with focal spikes in the EEG, in most cases a very benign form with an excellent prognosis. These 3 forms of seizure disorders may be divided in subgroups. The distinction of fine diagnostic nuances is quite helpful but requires well integrated epileptological and EEG experience. The special role of temporal lobe epilepsy is briefly discussed. Furthermore, several etiologies of childhood etiologies are singled out such as inborn errors of metabolism (lipidoses, amino-acidurias), essential hereditary myoclonus epilepsy, tuberous sclerosis, Sturg-Weber's disease, encephalitis, brain tumor and brain abscess. The fringe of the seizure ("borderland of epilepsy") is briefly delineated.

摘要

本文概述并讨论了儿童癫痫(不包括生命的头两年);特别强调了某些特定形式癫痫病症的多样性及其临床病程。这些形式分为以下几类:a) Lennox-Gastaut综合征:一种多病因病症,具有独特的临床发作期和脑电图特征,大多与智力缺陷相关,预后不佳。b) “常见全身性癫痫”(也称为“中央脑性”癫痫),其特征为失神小发作或失神小发作与大发作的组合,预后大多良好。c) 脑电图有局灶性棘波的儿童癫痫,多数情况下是一种非常良性的形式,预后极佳。这三种癫痫发作障碍形式可再分为亚组。区分细微的诊断差异很有帮助,但需要丰富的癫痫学和脑电图经验。文中简要讨论了颞叶癫痫的特殊作用。此外,还指出了一些儿童期病因,如先天性代谢缺陷(脂质沉积症、氨基酸尿症)、原发性遗传性肌阵挛癫痫、结节性硬化症、Sturge-Weber病、脑炎、脑肿瘤和脑脓肿。文章还简要描述了癫痫发作的边缘情况(“癫痫边缘地带”)。

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