睡眠中失神发作的儿童失神癫痫的临床特点(附1例报告)

Clinical features of absence epilepsy with childhood absence seizures during sleep (report of one case)

目的探讨睡眠中失神发作的儿童失神癫痫(CAE)的临床特征。方法回顾性分析1例睡眠中失神发作的CAE患儿的临床资料。结果本例患儿以反复愣神为主要表现,同时伴有睡眠中突然睁眼、茫然无视及轻微眨眼等症状,同期视频EEG均为全导广泛性3 Hz棘慢波阵发。空腹CSF检查及头颅MRI正常。先后给予丙戊酸、拉莫三嗪及左乙拉西坦治疗,疗效均不佳。结论若CAE患儿在睡眠中出现同清醒期一致的临床发作,同期EEG示广泛性棘慢波持续发放>2 s,需考虑睡眠中失神发作,且提示预后不佳。

Objective To explore the clinical features of childhood absence epilepsy(CAE) with absence seizures during sleep. Methods The clinical data of one CAE children with absence seizures during sleep were retrospectively analyzed.Results This patient presented with the recurrent sudden loss of awareness, and she also had repetitive movements similar to those seen while awake(such as eyes open and blinking) during sleep. Video EEG showed 3 Hz generalized spike-wave(GSW) discharges lasting several seconds when she presented with both losses of awareness and repetitive movements during sleep. Fasting CSF examination and craniocerebral MRI were normal. She was treated with valproic acid, lamotrigine and levetiracetam, but had poor efficacy. Conclusions If the child with CAE has a clinical episode consistent with the waking period during sleep, and simultaneous EEG showed widespread spinous slow waves lasting for more than 2 seconds, it can be considered as epileptic absence seizure during sleep, and it may indicate a poor prognosis of CAE.