婴幼儿体外循环术后继发癫痫20例分析

目的 探讨婴幼儿体外循环(CPB)术后继发癫痫的临床特征、治疗和预防。方法 1995—05—2002—05对20例婴幼儿先心病CPB术后继发癫痫的年龄、脑电图(EEG)、MRI等方面进行分析综合。结果 20例中，男14例，女7例。首发年龄：2个月一14岁，平均4岁2个月；其中小于6岁的婴幼儿多在CPB术后7d发病。微小发作(minimal seizure)及全身发作分别8例和5例。脑电图显示l周后多呈局限性或弥漫性慢波，异常放电波增多。6例行MRI检查提示局限性T2信号增强。结论 婴幼儿发病较早，年龄大者发病较晚，EEG及MRI有助于早期诊断和预后判断，对婴幼儿CPB术后癫痫治疗的重点应治疗和预防相结合。

Epilepsy in children after cardiopulmonary bypass:an analysis of 20 cases

Objective To summarize clinical features and therapeutic experience and preventation of epilepsy after cardiopulmonary bypass. Methods Twenty patients with epilepsy after surgery were retrospectively analyzed. The causes, preventation, treatment and diagnosis of epilepsy were fully evluated by using EEG, MRI and other clinical data. Results Twenty patients(14 males, 6 females)were studied. The onset ages of seizure were between 2 months and 14 years with an average of 4 years and 2 months. First seizure occurred mostly in the 7 days after surgery for patients less than 6 years. Minimal and generalized seizures occured in 8 and 5 patients, respectively. Electroencephalogram(EEG)revealed focally slow-waves and epileptic discharges which were apparently increased in day 7 after surgery. MRI suggested enhanced T 2-weighted spots in 6 cases. Conclusion Epilepsy after surgery with CPB occurs earlier in infants and later in the older children. EEG plays an important role in the early diagnosis and detection of subclinical epilepsy which might be valuable for assessing later prognosis.MRI has a high predictive value for epilepsy.