小儿失神癫痫临床特征和药物治疗观察

来源 :中国实用儿科杂志 | 被引量 : 0次 | 上传用户:kangbb
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目的 探讨小儿失神癫痫 (CAE)的临床特征及评价药物的疗效。方法 对 34例CAE的临床及实验室资料进行回顾性分析。结果 本组起病年龄是 4~ 11岁 ,4~ 8岁患病为多 (6 5 % ) ;简单失神 14例 (4 1% ) ,复杂失神 2 0例 (5 9% )。对 2 5例患儿取立位进行过度换气诱发实验 ,目测结果 :15例复杂失神可伴有不同临床表现 ,7例为简单失神。 34例异常脑电图 (EEG)为突然自发或过度换气后呈现双侧对称同步的 3Hz棘慢综合波。32例中 2 8例 (88% )智商 (IQ)正常 ,4例为边缘状态。本组患儿脑CT、MRI均正常。 34例均首选单药治疗 :2 6例用丙戊酸钠 ,5例用德巴金缓释片 ,用药至发作停止时间是 4天至 6个月 ,其中 <1个月者 18例 (5 8% ) ;另 3例单药治疗期间因故改用多药治疗。随访 6个月至 4年 ,单药治疗 31例中 2 5例 (80 % )完全控制发作平均 2年。结论 CAE发作分型的诊断 ,是依据临床表现及EEG特征。丙戊酸钠是治疗CAE反应良好的一线药物 Objective To investigate the clinical features of pediatric absence of epilepsy (CAE) and evaluate the efficacy of the drug. Methods Retrospective analysis of 34 cases of CAE clinical and laboratory data. Results The onset age of patients in this group was 4 to 11 years old, and the prevalence was much higher in patients aged 4 to 8 (65%). 14 cases (41%) were simple absences and 20 cases (59%) were complicated absences. Twenty-five cases of children were taken to hyperventilation induced test, visual inspection results: 15 cases of complex deafness may be associated with different clinical manifestations, 7 cases of simple absence. 34 cases of abnormal electroencephalography (EEG) for the sudden spontaneous or hyperventilation showed bilateral symmetrical 3Hz spike slow combination wave. Twenty-eight of 32 (88%) had normal IQ (IQ) and 4 had marginal status. This group of children brain CT, MRI are normal. 34 patients were the preferred monotherapy: 26 cases with sodium valproate, 5 cases with dekapton sustained release tablets, medication to stop the onset of time is 4 days to 6 months, of which <1 month in 18 cases (58 %); The other three cases of monotherapy for some reason switched to multi-drug treatment. During a follow-up period of 6 months to 4 years, 25 (80%) of the 31 patients treated with monotherapy completely controlled the onset of attack for an average of 2 years. Conclusions The diagnosis of CAE episode is based on clinical manifestations and EEG features. Sodium valproate is a first-line drug for the treatment of CAE
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