儿童与成人起病的伴海马硬化的颞叶癫癎对比分析

Analysis of clinical features of 201 patients with temporal lobe epilepsy with hippocampal sclerosis：comparison of children and adult onset group

目的对比分析儿童与成人起病组的伴海马硬化的颞叶癫癎（TLE-HS）患者临床特点的异同，以提高对该病的认识。方法：回顾性收集我院癫癎诊疗中心就诊的TLE-HS患者201例，依据患者起病年龄分成儿童起病组和成人起病组，收集病史、发作类型和频率、药物治疗、头部影像学、24 h视频脑电图（V—EEG）等临床资料，作对比分析。结果：儿童起病组较成人起病组伴热性惊厥（FS）史多、间断发作少，频繁发作多，差异均有统计学意义（P=0．013、0．013、0．013）；儿童起病组较成人起病组在发作间期EEG颞区以外癎样放电较多，差异有统计学意义（P=0．015）。两组患者在HS侧别、发作起源、发作类型、单用或联合用药、头部外伤史、脑炎史、家族史、精神发育迟滞、精神异常等方面比较差异均无明显统计学意义。结论：与成人起病组相比，儿童起病组伴FS史多，发作频率更高，这提示FS是导致癫癎患者更早起病的原因之一；儿童起病组发作间期EEG颞区以外癎样放电较多。

Objective：To explore the characteristics in patients with temporal lobe epilepsy （TLE） with hippocampal sclerosis（HS） on children and adult onset group,and to improve the understanding of the disease. Methods：201 patients with TLE - HS were divided into 2 groups according to the age. The disease history, the types of attacks and frequency, medications, head images, 24-hour video electroenceph- alogram （V-EEG） and other clinical data,of two groups were all analysed. Results：Children onset group had more frequents attack of febrile seizure（FS）. The adult onset group had less intermittent attacks and more frequent attacks,The differences was statistically significant （P = 0. 013,0. 013,0. 013, respective- ly）. Children onset group had more EEG outside temporal discharge than adult onset group. The difference was statistically significant （P=O. 015）. In the two groups on the hippocampal sclerosis side, there were no statistical significant differences origin of seizure, seizure types, single or united medication, head trauma history, history of encephalitis, family history, mental retardation, mental disorder, etc. Conclusion： Compared with the adult onset group, children with TLE-HS have more frequent FS attack leading to more early epileptic and frequent seizure. Children onset group has more EEG outside temporal discharge than adult onset group.