婴儿百日咳脑病2例爆发抑制脑电分析

Analysis of electroencephalogram in 2 cases of infancy pertussis encephalopathy burst suppression

回顾性分析2022年9月至2022年10月华中科技大学同济医学院附属武汉儿童医院收治的2例百日咳脑病患儿的资料,总结其临床特点及诊治方法,结果发现2例发病年龄均在3月龄内,其中1例有咳嗽患者接触史,颅脑磁共振成像(MRI)均未见感染病灶,2例惊厥发作均发生于病程的2~3周,病程第5~7周脑电图(EEG)存在爆发抑制改变,病例1使用托吡酯片+左乙拉西坦后,改善脑电情况;病例2最终使用托吡酯片+丙戊酸钠联合治疗后,改善脑电情况。文献分析后认为,百日咳脑病多见于未接种百日咳疫苗的小月龄婴儿,多数因接触咳嗽家属后发病,其惊厥发作与脑电改变无关,文章发现托吡酯片能有效控制发作,同时联合其他抗发作药物显示脑电改善。

The data of 2 children with pertussis encephalopathy admitted to Wuhan Children's Hospital,Tongji Medical College,Huazhong University of Science and Technology from September 2022 to October 2022 were retrospectively analyzed,and their clinical characteristics,diagnosis and treatment methods were summarized.It is found that the onset age of the 2 children with pertussis encephalopathy was within 3 months,and 1 of them had a history of contact with patients with cough,and no infection lesions were found in brain MRI.The convulsive seizures of the 2 children occurred at 2-3 weeks in the course of the disease,and the outbreak inhibition of EEG was present at 5-7 weeks in the course of the disease.In case 1,the EEG condition could be improved after the use of topax+levetiracetam.In case 2,the electroencephalogram was finally improved by the combination of topac and valproic acid.The literature analysis shows that pertussis encephalopathy is more common in infants of small months who have not received pertussis vaccine,most of which are caused by contact with coughing family members,and convulsive seizures are not correlated with EEG changes.This paper shows that topathy can effectively control seizures,and at the same time,by combination with other anti-seizure drugs EEG improvement is achieved.