脑性瘫痪患儿合并癫疒间32例临床分析

目的探讨合并癫疒间的脑性瘫痪患儿的临床特点及癫疒间治疗效果。方法总结1999年10月至2004年5月在西安交通大学第二医院住院的合并癫疒间的脑性瘫痪患儿的癫疒间发生率、临床类型、头颅计算机体层成像(CT)和(或)磁共振成像(MRI)、脑电图等方面的特点以及抗癫疒间治疗效果。结果139例脑性瘫痪患儿中有32例合并癫疒间，占230%(32/139)；常见的癫疒间类型为强直 阵挛发作12例(375%)和部分性发作6例(188%)；25例(781%)癫疒间首发于1岁前；合并癫疒间脑性瘫痪儿童的头颅影像异常及脑电图异常分别占30例(938%)和27例(844%)；常见的头颅影像异常为脑发育不良11例(367%)、脑积水6例(200%)，余为脑萎缩、缺氧缺血性脑病样改变等13例(433%)；脑电图异常中局灶性和弥漫性所占比例分别为482%(13/27)和518%(14/27)；癫疒间多发生于痉挛性脑性瘫痪中(688%)；813%(26/32)的癫疒间需要2种及2种以上的抗癫疒间药物治疗。结论脑性瘫痪患儿中癫疒间的发生率较高，其头颅影像学和脑电图分别以脑发育不良和弥漫性背景活动异常伴疒间样波发放为主；脑性瘫痪儿童的癫疒间大多为难治性，需要联合用药治疗。

Clinical analysis of epilepsy in 32 children with cerebral palsy.

AbstractObjectiveTo explore the clinical characteristics of cerebral palsy(CP) children with epilepsy and therapeutic effect on epilepsy.MethodsTo sum up the incidence of epilepsy,clinical type,the age of first seizure,brain computer tomography(CT) and/ or magnetic resonance imagery(MRI),electroencephalogram(EEG),and therapeutic effect on epilepsy in CP children with epilepsy from Oct. 1999 to May 2004 in the Second Hospital of Xi'an Jiaotong University.ResultsThere were 32 epileptic cases in the total 139 children with CP,the percentage of epilepsy being 230%(32/139).The common type of epilepsy were tonic clonic (375%) and partial(188%) seizures781% epilepsy occurred in under the age of one year.The percentages of abnormal brain image and EEG were 938% and 844% respectively.The main abnormal brain images were cerebral hysplasia(367%) and hydrocephalus(200%).The percentages of focal and diffused changes in EEG were 482%(13/27) and 518% (14/27) respectively.688% epilepsies occurred in spastic CP children.813%(26/32) epilepsies should be treated by polytherapy with 2 or more than 2 antiepileptic drugs.ConclusionThe incidence of epilepsy in CP children is high.The main changes of brain image and EEG are cerebral hysplasia and abnormal background activities with epileptic waves respectively.Most of the epilepsies in children with CP are intractable ones and need polytherapy.