摘要
目的：分析小儿病毒性脑炎后痉挛发作的临床及录像脑电图特征。方法：回顾分析了25例病毒性脑炎患儿并痉挛发作的临床及录像脑电图资料。结果：25例患儿中，男15例，女10例；年龄最小8个月，最大7岁零2个月，平均2岁零10个月。临床表现、脑脊液与影像学均符合病毒性脑炎标准。痉挛发作发生在起病后30～90d，22例（88％）患儿的痉挛发作不成串，3例（12％）为成串痉挛发作，6例（24％）为不对称痉挛发作；脑电图背景节律均不正常，18例患儿存在局灶性或一侧性慢波，发作间期癎样放电为局灶性、一侧性或广泛性，仅2例（8％）患儿为高度节律紊乱。7例伴有部分性发作，5例伴有肌阵挛发作，4例伴不典型失神发作，2例伴有强直发作。25例患儿经丙戊酸钠、左乙拉西坦、妥泰、拉莫三嗪或激素等治疗，11例（44％）发作无变化，9例（36％）发作减少≤50％，5例（20％）发作减少≥50％，无1例发作完全消失。结论：病毒性脑炎患儿的痉挛发作出现在疾病的恢复期，痉挛发作不成串，脑电图无高度节律紊乱，治疗困难。
Objective： To analyse clinical and video electroencephalogram （V-EEG） characters of children with viral encephalitis during epileptic spasms onset. Methods： Retrospective analysis of 25 chil- dren with viral encephalitis during epileptic spasms onset was made with their clinical diagrosis and V- EEG. Results：In the 25 patients with severe encephalitis , there were 15 male and 10 female. The mean age was 2.83 years（from 8 months to 7.17years）. The clinical history,CSF and neuroimages were in ac- cordance with the diagnosis of severe encephalitis. The spasm onset time was 30～90 days after the diag- nosis of severe encephalitis. A string of seizures occurred in 3 cases （12%）, non-string seizures in 22 （88 %）, asymmetric seizures in 6（24 %）. The V-EEG results were all abnormal and focal or lateral slow waves in were in 18 cases（72）, with focal, lateral or general epileptic discharges during inter-ictal phase,and hypsarrhythmia was in 2 cases（8%） . About the seizure type of the patients , partial seizure was in 7 cases, myoclonic seizure in 5, atypical absence seizure in 4,tonic seizure in 2 . The patients was treated with sodium valproate, levetiracetam, topiramate, lamotrigine or hormonotherapy etc, no seizure free seizures decreased by ≥50% in 5 cases（20%） ,seizures decreased by ≤50% in 9（36%） ,no seizure in 11 controls （44 % ）. No serzure dissappeared in any case. Conclusion：Children with viral encephalitis u- sually have spasms onset during recovery phase, with non-string seizures , non-hypsarrhythmia in EEG do not respond to drugs.
出处
《癫痫与神经电生理学杂志》
2014年第6期335-337,共3页
Journal of Epileptology and Electroneurophysiology(China)
关键词
癫癎性痉挛
脑电图
病毒性脑炎
epileptic spasms
EEG technology
viral encephalitis
