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有儿童期热性惊厥病史患者的癫痫诊断与定位

Epilepsy diagnosis and localization in patients with antecedent childhood febrile convulsions.

作者信息

Hamati-Haddad A, Abou-Khalil B

机构信息

Department of Neurology, Vanderbilt University, Nashville, TN 37212, USA.

出版信息

Neurology. 1998 Apr;50(4):917-22. doi: 10.1212/wnl.50.4.917.

Abstract

PURPOSE

A history of febrile convulsions (FC) is often obtained in patients presenting for surgical treatment of temporal lobe epilepsy (TLE), but it is not clear that preferential temporal localization of epilepsy is associated with antecedent FC.

METHODS

We prospectively inquired about FC and their characteristics in all patients presenting to an epilepsy clinic through a patient questionnaire and interview. We studied the incidence of antecedent childhood febrile convulsions in relation to epilepsy diagnosis.

RESULTS

FC were reported by 133 of 1005 study patients (13.2%). TLE was more likely to be preceded by FC (78/310, 25.2%) than extratemporal epilepsy (ETE) (12/216, 5.6%) (p < 0.000001) or generalized epilepsy (GE) (16/146, 11.0%) (p < 0.001). Patients with GE were more likely than patients with TLE to have had simple FC (p < 0.00005). Prolonged duration was the most common FC complex feature in TLE patients.

CONCLUSIONS

We demonstrated a preferential association of FC with temporal lobe foci and a weaker association between FC and GE. FC does not appear to be a clear risk factor for ETE.

摘要

目的

在因颞叶癫痫(TLE)接受手术治疗的患者中,常常能了解到有高热惊厥(FC)病史,但尚不清楚癫痫的颞叶优先定位是否与既往的FC相关。

方法

我们通过患者问卷和访谈,前瞻性地询问了所有到癫痫门诊就诊患者的FC及其特征。我们研究了既往儿童高热惊厥的发生率与癫痫诊断之间的关系。

结果

1005例研究患者中有133例报告有FC(13.2%)。与颞叶外癫痫(ETE)(12/216,5.6%)(p<0.000001)或全身性癫痫(GE)(16/146,11.0%)(p<0.001)相比,TLE更有可能有FC病史(78/310,25.2%)。GE患者比TLE患者更有可能有单纯性FC(p<0.00005)。惊厥持续时间延长是TLE患者最常见的FC复杂特征。

结论

我们证明了FC与颞叶病灶之间存在优先关联,而FC与GE之间的关联较弱。FC似乎不是ETE的明确危险因素。

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