摘要
目的探讨孤独症合并癫患儿的临床、脑电图(EEG)特征及治疗效果。方法对56例孤独症合并癫患儿应用抗癫药物治疗,治疗前后行EEG检查,观察其预后,并对临床特点及EEG进行分析。结果孤独症合并癫患儿中,癫发作类型以局限性发作最为常见(75%),其中63%是复杂局限性发作。其他较常见的发作形式是强直性发作(36%)和热性惊厥(27%),强直-阵挛性发作、失张力发作、不典型失神发作等发作形式也可出现。EEG主要表现为阵发性异常,包括背景活动减慢、阵发性快活动、阵发性δ活动、阵发性θ活动等非特异改变10例,以及局灶性、多灶性、弥散性尖(棘)波、尖(棘)慢波活动等性放电46例,其中位于颞叶26例(46%),额叶10例(18%),中央区9例(16%),枕叶6例(10%)。病变部位双侧局灶性29例(52%),单侧局灶性19例(34%),弥散性异常改变8例(14%)。经正规抗癫治疗,77%的病例获得1 a以上无发作控制效果,其中63%单药治疗有效,37%的患儿联合用药有效,23%的患儿未能获得控制。结论孤独症合并癫患儿存在不同类型的癫发作形式,局限性发作为其最常见的发作形式,大部分为复杂局限性发作。EEG主要表现为阵发性异常,部分出现癫样放电,EEG异常多起源于颞叶,多双侧出现。抗癫药物对于这类患者的癫发作有很好的控制效果,与其他原因所致癫治疗效果类似。
Objective To investigate the clinical features,electroencephalogram（EEG） and therapeutic effect of autism combined with epilepsy in children.Methods A retrospective review was conducted in 56 children who were diagnosed as autism combined with epilepsy.The epilepsy was treated,and the clinical features and EEG were analyzed.Results Forty-two（75%） cases of 56 patients were found to have partial seizures,which was most common,of which 63% were complex partial seizures.Other common seizure types were tonic seizures（36%） and febrile convulsion（27%）,but tonic-clonic seizures,atonic seizures,atypical absence seizures and other forms of attack could occur also.Focal and multifocal paroxysmal abnormalities were the main characteristics of EEG,which mainly included background activity slowing,paroxysmal fast activity,paroxysmal theta and delta activity and the activities of non-specific focal,multifocal or diffuse sharp（spine） wave,sharp（spike） slow wave and other abnormal epileptiform EEG abnormalities.Epileptic foci were localized in temporal lobe in 26 cases（46%）,10 cases（18%） in the frontal lobe,9 cases（16%） in the central region and 6 cases（10%） in the occipital lobe.Focal EEG paroxysmal abnormalities were mainly in the bilateral lobe region in 29 cases（52%） cases,unilateral focal lesions in 19 cases（34%）,diffuse abnormalities in 8 cases（14%）.Seventy-seven percent children had seizure-free effect for more than 1 year,most of whom（63%） were treated with monotherapy while others（37%） required combination therapy,and 23% of the patients failed to have seizure-free effect.Conclusions There are several types of epileptic seizures in autistic children,and partial seizure is the most common one,in which the most were complex partial seizures.Paroxysmal abnormalities are the main characteristics on EEG.The epileptiform discharges on EEG are more frequently shown in the temporal lobe,often bilaterally.The outcome of treatment with antiepileptic drugs is similar to th
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2011年第10期781-783,共3页
Journal of Applied Clinical Pediatrics
基金
深圳市医学重点专科基金(2001B20)
关键词
孤独症
癫痫
脑电图
临床特点
治疗
儿童
autism
epilepsy
electroencephalogram
clinical feature
therapy
child
