儿童癫癎伴枕叶癎样放电临床分析

Clinical analysis of childhood epilepsy with occipital paroxysms

目的分析儿童癫癎伴枕叶癎样放电病例临床特点的差异,提高对儿童枕叶癎样放电的认识和诊断水平。方法对38例显示发作间期的棘波和(或)尖波出现在枕区、后颞-顶区的患儿的病例资料进行了回顾性分析,运用x^2检验或Mann-WhitneyU检验,对流行病学数据、发作时症状、脑电图、神经影像学资料、治疗反应和预后进行比较。结果特发性组有4例有神经系统疾病的家族史,且癫癎发作次数明显少于症状性组,两组都表现有自主神经症状,但在Panayiotopoulos型的患儿中发作性呕吐及眼球偏视更常见。特发性组的预后明显优于症状性组(P<0.05)。结论Panayiotopoulos综合征更为常见,神经病学的缺陷和脑电图的特点是预测儿童枕叶癫癎能否缓解的主要因素。通常具有较好的预后。

paroxysms. Objective To analyse the differences between idiopathic and symptomatic childhood epilepsy with occipital Methods The medical records of 38 patients with interictal spikes and/or sharp waves over occipital areas, posterior temporal-parietal areas, or both were retrospectively analysed. Epidemiological data, ictal symptoms, electroencephalogram, neuroimaging studies, treatment response and prognosis were compared using chi-square test or Mann-Whitney U test. Results Four patients of idiopathic group had positive family history related to nervous system. Seizures were more frequent in symptomatic group than in idiopathic group. Both groups showed autonomic symptoms, while ictal vomiting and deviation of eyes were more common in the presence of Panayiotopoulos type. The prognosis of idiopathic group was much better than that of symptomatic group. Conclusion Panayiotopoulos syndrome is more common. Neurologie deficits and electroencephalographic characteristics are major factors to predict seizure remission in children with occipital lobe epilepsy. Idiopathic childhood epilepsy with occipital paroxysms may result in better prognosis.