脑性瘫痪合并癫痫的康复治疗原则探讨

目的探讨小儿脑瘫（CP）合并癫痫的康复治疗方法。方法从1402例CP中筛查出140例癫痫进行CP类型、癫痫类型、MRI或CT、脑干听觉诱发电位（BAEP）分析，并进行康复治疗，方法包括抗癫痫药物、电刺激、针灸、封闭、脑蛋白水解物、功能训练、按摩、中药熏蒸、脑苷肌肽的应用等，观察患儿的疗效。结果本组合并EP的CP患儿以痉挛型为主，癫痫类型以婴儿痉挛、肌阵挛多见；98％MRI或CT异常，90％BAEP异常；抗癫痫药物治疗均有效；电刺激、针灸、封闭、脑蛋白水解物均能加重癫痫发作；功能训练、按摩、中药熏蒸、脑苷肌肽不会加重癫痫发作。结论小儿CP合并癫痫的康复治疗原则为及早、长期应用抗癫痫药物，避免电刺激、针灸、封闭、脑蛋白水解物等治疗，提倡功能训练、按摩、中药熏蒸、脑苷肌肽等治疗。

Principles of Rehabilitation Treatment for the Cerebral Palsy Children Complicated with Epilepsy

ObjectiveTo investigate advantage and disadvantage of different rehabilitation therapies used for cerebral palsy (CP) children complicated with epilepsy (EP).Methods140 CP children complicated with EP screened from 1402 CP cases, were analyzed for CP and EP types, MRI or CT, brain stem auditory evoked potentials (BAEP). All cases were treated with anti-epilepsy drugs (AEDs). Different rehabilitation therapies, including electrotherapeutic modalities, acupuncture, point injection, cerebroprotein hydrolysate injection, manual therapy, functional training, Chinese herb braising therapy, and cattle encephalon glycoside and ignotin injection were assessed.ResultsIn all 140 cases, a majority of EP types were myoclonic seizure and west syndrome, CP type was spasticity. Abnormality showed in MRI or CT (98%) and BAEP (90%). AEDs were effective for all 140 cases. Electrotherapeutic modalities, acupuncture, point injection, and cerebroprotein hydrolysate injection could make EP severely, but manual therapy, functional training, Chinese herb braising therapy, cattle encephalon glycoside and ignotin injection had no adverse effects on EP cases.ConclusionThe principles of rehabilitation treatment for the CP children complicated with EP are taking AEDs early and in a long term, avoiding electrotherapeutic modalities, acupuncture, point injection, and cerebroprotein hydrolysate injection, using manual therapy, functional training, Chinese herb braising therapy, and cattle encephalon glycoside and ignotin injection.