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目的探讨儿童额叶癫(FLE)的临床表现、EEG特点及预后,提高对FLE的认识。方法对郑州大学第三附属医院小儿神经内科门诊2009年6月-2010年6月诊治的24例FLE患儿临床资料进行回顾性分析,患儿均行24h视频脑电图(VEEG)监测和头颅影像学检查,分析儿童FLE的发作类型、发作表现、临床特点、EEG、头颅影像学表现,以及口服抗癫药物的治疗效果等。结果临床发作表现为类抽动症样发作6例(25.00%),类行为异常样发作、躯体运动性自动症各5例(20.83%),简单自动症3例(12.50%),偏转性强直发作、阵挛性发作各2例(8.33%),姿势性强直发作1例(4.17%)。以睡眠中发作为主,发作频繁,持续时间短暂,常有连续成串发作。患儿均有额区异常放电,主要表现为额区起源的尖波、尖慢波、棘波、棘慢波、多棘慢波、慢波等或以上混合,可波及中央、颞区甚至泛化全导。头颅影像学检查发现异常5例。口服抗癫药物治疗控制发作21例(87.5%),发作减少3例(12.5%)。结论 FLE临床表现复杂多样,以类抽动症样发作、类行为异常样发作及躯体运动性自动症为主要表现,发作以睡眠中为主,持续时间短暂,且常规EEG阳性率低,易误诊,长程VEEG监测可提高检出率。口服抗癫药物治疗效果良好。
Objective To investigate the clinical manifestations, EEG features and prognosis of children with frontal lobe epilepsy (FLE) and to improve their understanding of FLE. Methods The clinical data of 24 FLE children diagnosed and treated from June 2009 to June 2010 in the Department of Pediatric Neurology, the Third Affiliated Hospital of Zhengzhou University were retrospectively analyzed. All patients underwent 24-hour VEEG monitoring and cranial Imaging examination, analysis of children with FLE seizure type, seizure performance, clinical features, EEG, head imaging performance, and the efficacy of oral anti-epileptic drugs. Results The clinical manifestations were as follows: six cases of tic disorder (25.00%), abnormal behavior of the class behavior, 5 cases of somatic motility autoimmune (20.83%), 3 cases of simple autoimmune diseases (12.50% , Two cases of clonic seizures (8.33%) and one case of posture tonic seizures (4.17%). Attack mainly in sleep, seizures frequent, short duration, often continuous string attack. There are abnormal discharge in frontal area of children, which mainly includes spikes, sharp and slow waves, spikes, spikes and slow waves, spikes and slow waves, slow wave and more or more mixed in the frontal area, which can affect the central and temporal areas and even pan All-round. Cranial imaging examination found abnormalities in 5 cases. Oral antiepileptic drug treatment control seizures in 21 cases (87.5%), seizures decreased in 3 cases (12.5%). Conclusions The clinical manifestations of FLE are complex and diverse. The main manifestations are seizures, abnormal behavior of so-called behavior and somatic autonomic disorders. The onset of seizure is mainly in sleep, the duration is short, and the positive rate of routine EEG is low, it is easy to be misdiagnosed, Long-range VEEG monitoring can increase the detection rate. Oral antiepileptic drug treatment is good.