Fusco L, Vigevano F
Section of Neurophysiology, Bambino Gesù Children's Hospital, Rome, Italy.
Epilepsia. 1993 Jul-Aug;34(4):671-8. doi: 10.1111/j.1528-1157.1993.tb00445.x.
The electroencephalographic/video recordings of 955 spasms in children with cryptogenic and symptomatic West syndrome (WS) were reviewed to define the relation between a clinical manifestation of a spasm and its EEG pattern, and to examine whether these features reflect the etiology and prognosis of WS. The review confirmed the spasm to be a distinct type of seizure, with a unique clinical and EEG pattern unlike that of all other recognized seizures. Symmetric spasms were present in cryptogenic and symptomatic patients. In contrast, asymmetric spasms, or focal signs recognizable during a spasm, strongly indicated the existence of a cerebral lesion. In both etiological groups, the characteristic ictal EEG pattern of the spasms consisted of a positive-vertex slow wave. The other two patterns apparently correlated to a spasm, were fast activity, here called spindle-like, and decremental activity. The fast activity corresponded to a clinical stare, and the decremental activity, when present, represented a postictal event. Although it was independent from the etiology of the spasms, persisting hypsarrhythmia during a cluster of spasms appeared to be an EEG pattern that correlated with a favorable outcome.
回顾了955例隐源性和症状性韦斯特综合征（WS）患儿痉挛发作的脑电图/视频记录，以确定痉挛发作的临床表现与其脑电图模式之间的关系，并研究这些特征是否反映WS的病因和预后。该回顾证实痉挛是一种独特的癫痫发作类型，具有独特的临床和脑电图模式，不同于所有其他已确认的癫痫发作。隐源性和症状性患者均出现对称痉挛。相比之下，不对称痉挛或痉挛发作时可识别的局灶性体征强烈提示存在脑损伤。在两个病因组中，痉挛发作的特征性发作期脑电图模式均为正相顶点慢波。另外两种明显与痉挛相关的模式是快速活动，这里称为纺锤样，以及递减活动。快速活动对应临床凝视，递减活动（若存在）代表发作后事件。尽管它与痉挛发作的病因无关，但在一组痉挛发作期间持续存在的高峰失律似乎是一种与良好预后相关的脑电图模式。
