Carmant L, Kramer U, Holmes G L, Mikati M A, Riviello J J, Helmers S L
Department of Neurology, Hôpital Ste-Justine, Montréal, Québec, Canada.
Pediatr Neurol. 1996 Apr;14(3):199-202. doi: 10.1016/0887-8994(96)00080-x.
Staring is frequently a nonepileptic manifestation in children. To differentiate epileptic versus nonepileptic staring, we reviewed clinical and video-EEG findings in 143 patients, aged 5 months to 43 years, monitored for staring episodes. In 79 patients staring was of epileptic origin; 46 had partial seizures and 33 atypical absence. Thirty-five had behavioral staring, 8 psychogenic seizures, 1 a migraine equivalent, and in 20 no staring spells were recorded. In all patients with epileptic staring, epilepsy was suspected clinically. Only 22 of the admissions for behavioral staring and 3 for pseudoseizures were to exclude a possible nonepileptic phenomenon. Review of their clinical histories revealed that certain findings strongly support a nonepileptic origin. In conclusion, a careful clinical history will differentiate between epileptic and nonepileptic staring episodes in most patients. Video-monitoring is helpful to adjust treatment or to exclude nonepileptic events in patients with refractory staring spells.
凝视在儿童中常常是非癫痫性表现。为了区分癫痫性凝视与非癫痫性凝视，我们回顾了143例年龄在5个月至43岁之间因凝视发作而接受监测的患者的临床及视频脑电图结果。79例患者的凝视源于癫痫；46例为部分性发作，33例为非典型失神发作。35例为行为性凝视，8例为精神性发作，1例为偏头痛等效症，20例未记录到凝视发作。在所有癫痫性凝视患者中，临床上均怀疑患有癫痫。因行为性凝视入院的患者中仅有22例以及因假性发作入院的患者中有3例是为了排除可能的非癫痫现象。对他们临床病史的回顾显示，某些发现强烈支持非癫痫性起源。总之，详细的临床病史在大多数患者中能够区分癫痫性和非癫痫性凝视发作。视频监测有助于调整治疗方案或排除难治性凝视发作患者的非癫痫性事件。
