Gouider R, Ibrahim S, Fredj M, Gargouri A, Saïdi H, Ouezzani R, Malafosse A, Yahiaoui M, Grid D, Mrabet A
Service de Neurologie, EPS Charles Nicolle, Tunisie.
Rev Neurol (Paris). 1998 Jul;154(6-7):503-7.
We describe clinical, electrophysiological and genetic features in 44 patients with Unverricht-Lündborg disease from 19 families living in North African countries (Tunisia, Algeria and Morocco). The mean age of patients was 25.3 years; mean age was at onset 11.3 years. The disease began more frequently with seizures (91 per cent) or myoclonus (80 p. 100) than ataxia (16 p. 100). Subsequently myoclonus and generalized seizures were present in all patients, cerebellar signs were absent in four cases. EEG findings included normal background activity (90 p. 100), spontaneous fast generalized spikes (93 p. 100) and photosensitivity (70 p. 100). Antiepileptic polytherapy (clonazepam and/or phenobarbital and/or valporic acid) was used in 84 per cent of cases. Antiepileptic drugs were more effective in controlling epileptic seizures (less than one seizure/month in 60 p. 100) than myocloni which persisted daily in 64 p. 100 of cases. Mean duration of the disease was 13.5 years. One patient died of status epilepticus. Consanguinity was noted in 17 families (first degree in 15 families). Linkage to chromosome 21q 22.3 was confirmed in 11 families. We noted an inter and intrafamilial variability of clinical signs and disease course.
我们描述了来自北非国家(突尼斯、阿尔及利亚和摩洛哥)19个家庭的44例昂韦里希特-伦德伯格病患者的临床、电生理和遗传特征。患者的平均年龄为25.3岁,发病时的平均年龄为11.3岁。该疾病开始时更常见的症状是癫痫发作(91%)或肌阵挛(80%),而非共济失调(16%)。随后,所有患者均出现肌阵挛和全身性癫痫发作,4例患者无小脑体征。脑电图检查结果包括正常背景活动(90%)、自发性快速全身性棘波(93%)和光敏感性(70%)。84%的病例使用了抗癫痫联合治疗(氯硝西泮和/或苯巴比妥和/或丙戊酸)。抗癫痫药物在控制癫痫发作方面更有效(60%的患者癫痫发作频率低于每月1次),而64%的病例中肌阵挛每天持续存在。疾病的平均持续时间为13.5年。1例患者死于癫痫持续状态。17个家庭存在近亲结婚情况(15个家庭为一级亲属)。11个家庭证实与21号染色体q22.3区域连锁。我们注意到临床体征和疾病进程在家族间和家族内存在变异性。