66例儿童可疑头痛性癫癎随访分析

Study on the suspicious diagnosis of headache epilepsy in 66 children

目的：探讨头痛性癫痫的诊断及与偏头痛的鉴别诊断。方法：分析由基层医院诊断为头痛性癫痫的66例患儿的临床资料，经详细询问病史，进行仔细的体格检查，复查脑电图（EEG）1～3次后，重新确定诊断，实施治疗并进行临床随访。结果：在此66例患儿中，28例纠正诊断为偏头痛，32例纠正诊断为神经性头痛。复查EEG结果显示大部分在正常范围，部分异常EEG中以弥漫性慢波增多为主，仅有6例EEG显示有散在痫样波，结合临床表现符合头痛性癫痫的诊断。结论：头痛性癫痫临床少见，单纯以头痛表现诊断为癫痫是不可靠的，必须依靠临床表现、EEG检查结果综合判断，并和偏头痛进行鉴别。以头痛为主诉的儿童不应轻易诊断为癫痫。

Objective：To investigate and compare the diagnoses of headache epilepsy and differential diagnoses of headache epilepsy from migraine. Methods：Clinical date of 66 patients with headache epilepsy diagnosed by other hospital,were analysed. The history of deseases was inquired, and physical examination was performed. EEG was reexamined for 1-3 times. After the diagnoses were made again, the patients were followed up. Results： Magraine in 28 of, and nervous headache in 32 of the 68 patients were found. In most patients,EEG was normal, or diffused slow waves were increased , and only 6 of the 66 patients showed abnormal EEG with sporadic epileptic waves . The manifestations were in accordance with the diagnosis of headache epilepsia. Conclusions： Headache epilepsia is rare clinically. It is not reliable to diagnose it as headache epilepsy with manifestation of heaache only. The diagnosis should be de- pendant on the clinical manifestation and EEG findings, and this disease should be differentiated from migraine.