Carrazana E J, Lombroso C T, Mikati M, Helmers S, Holmes G L
Department of Neurology, Children's Hospital, Harvard Medical School, Boston, Massachusetts.
Epilepsia. 1993 Jan-Feb;34(1):97-109. doi: 10.1111/j.1528-1157.1993.tb02381.x.
We report 16 patients with infantile spasms in whom onset of the clusters of spasms appeared to be triggered by close temporal association with partial seizures. Common features included the presence of focal cerebral lesions in 12 infants (3 were classifiable as cryptogenic); all had partial seizures with EEG localization, clusters of bilateral spasms always preceded by partial seizures, and response to adrenocorticotropic hormone (ACTH) and traditional antiepileptic drugs (AEDs) generally was poor. Three had complete agenesis of the corpus callosum, which argues against interhemispheric callosal spread of focal discharges resulting in the generalized spasms. Surgical cortical resections were performed in 6 of the infants, with good outcomes. This group of patients supports a model in which the spasms, although probably generated at a subcortical level, are facilitated or possibly induced by focal discharges from cortical pathology.
我们报告了16例婴儿痉挛症患者，其痉挛发作簇的起始似乎是由与部分性癫痫在时间上的紧密关联所触发。常见特征包括12例婴儿存在局灶性脑损伤（3例可归类为隐源性）；所有患者均有脑电图定位的部分性癫痫发作，双侧痉挛发作簇总是先于部分性癫痫发作，并且对促肾上腺皮质激素（ACTH）和传统抗癫痫药物（AEDs）的反应通常较差。3例患者胼胝体完全缺如，这表明局灶性放电通过半球间胼胝体传播导致全身性痉挛的观点不成立。6例婴儿接受了手术皮质切除术，效果良好。这组患者支持一种模型，即痉挛虽然可能在皮质下水平产生，但由皮质病变的局灶性放电所促进或可能诱发。
