儿童腔隙性脑梗死与癫痫发作的关系

RELATIONSHIP BETWEEN LACUN A CEREBRAL INFARCTION AND EPILEPTIC SEIZURES IN CHILDREN

①目的 探讨儿童腔隙性脑梗死 (LCI )与癫痫发作的关系及其临床特点。②方法 回顾并对比分析 16例首发表现为痫性发作的病儿以及 4 4 4例非LCI癫痫病儿的临床资料。③结果 LCI癫痫发作病儿发病年龄、发作类型、相关病史、EEG与MRI或CT的定位一致性以及抗癫痫药物疗效等均与非LCI痫性发作病儿有显著差异 (χ2 =10 .5 7～ 30 .6 6 ,P <0 .0 5、0 .0 1)。特别是LCI痫性发作病儿在痫性放电灶、影像学表现、发作类型及神经系统定位体征等方面存在非常高的定位一致性。④结论 LCI可能是部分儿童隐源性癫痫的主要原因之一。临床上对低龄癫痫儿童应常规进行EEG和MRI或CT检查 。

Objective\ To explore the clinical characteri stics of and the relationship between lacuna cerebral infarction (LCI) and epile ptic seizures in children. \ Methods\ Clinical data of 16 LCI children with epileptic seizures and 444 non LCI epileptic children were analyzed and compared. \ Results\ LCI children with epileptic seizures differed significant ly from non LCI children in age, seizure type, corresponding history, correlati on of EEG and CT/MRI localization, and the effect of anticonvulsants ( χ 2=10 .57-30.66;P <0.05,0.01). Particularly, there was fine correlation of localizati on in discharging lesion, imaging findings, seizure types and neurological signs in LCI children with epileptic seizures. \ Conclusion\ LCI might be one of main causes of some cryptogenic ep ilepsy in children. Clinically, routine check of EEG and MRI/CT should be applie d on children with epilepsy to make an early diagnosis of the cause of LCI.