论文部分内容阅读
患者 女性,15/2岁,以反复发作性晕厥,四肢抽搐4年余于1993年10月3日住院。病孩1989年8月开始无任何诱因反复出现胸闷,心前区不适,继即晕厥,四肢抽搐,神志不清,小便失禁,持续约10～15秒左右自行缓解,发作后伴头痛、疲乏、嗜睡,病后不伴听力减退,仍能坚持上学,成绩中等。两岁半时曾不慎头部轻微撞伤,当时神志清楚,未经特殊处理。无药物过敏史,足月顺产,家族中否认同类病史。病后就诊当地医院,拟诊为低血钙性抽搐,治疗效果欠佳,此后3年多来先后就诊广州7间医院,多次脑电图检查:换气后各导联见散在短程4～7c/sθ波,中高度波幅,尤于前半球为显著,或似出现癫痫样放电,但亦有表现为正常者,ECG示QT间期延长,U波增大,T波有切迹,心肌劳损,电解质检查,胸片及颅脑CT均正常,诊断为癫痫;抽搐原因待查;脑局限性缺血后遗症,继发性癫痫等,口服丙戊酸钠,卡马西平,大仑丁及脑细胞代谢药物治疗,症状时好时坏。体查未发现明显阳性体征。
Female patients, 15/2 years old, with recurrent syncope, limbs twitch more than 4 years in October 3, 1993 hospitalization. Patient August 1989 began without any incentive repeated chest tightness, precordial discomfort, then fainting, limbs convulsions, confusion, urinary incontinence, sustained about 10 to 15 seconds to ease, after the onset of headache, fatigue, Drowsiness, after the illness without hearing loss, still insist on going to school, the result is medium. Two and a half years old had a slight head injury, was conscious, without special treatment. No history of drug allergy, term full-term birth, the family denied the same history. After visiting the local hospital after the illness, to be diagnosed as hypocalcemia convulsions, the treatment effect is poor, then see more than 3 years in Guangzhou 7 hospitals, multiple EEG examination: ventilation after the lead see scattered in the short-range 4 ~ 7c / sθ wave, medium and high amplitude, especially in the anterior hemisphere as significant, or may appear epileptiform discharge, but also showed normal, ECG QT prolongation, U wave increases, T wave notch, myocardial Fatigue, electrolyte tests, chest X-ray and CT were normal, the diagnosis of epilepsy; convulsions to be investigated; cerebral ischemic sequelae, secondary epilepsy, oral sodium valproate, carbamazepine, Dalun Ding and Metabolic drug treatment of brain cells, the symptoms of good and bad time. Physical examination found no significant positive signs.