麻将反射性癫痫的临床特点

目的：分析麻将反射性癫痫的临床特点，探讨其可能的病因和发病机制。方法：对2016至2018年在中南大 学湘雅三医院门诊诊断的15例麻将反射性癫痫患者(研究组)的病史、脑电图、头部MRI等临床资料进行系统整理，并 与文献报道的84例麻将反射性癫痫患者(文献组)资料进行比较。结果：研究组和文献组麻将反射性癫痫均好发于中 年男性，发病年龄分别为(44.53±10.58)岁和(41.48±17.85)岁。研究组发作前打麻将至癫痫发作的时间为(4.00±2.45) h； 73.3%的患者有疲劳感；发作形式以全面性发作为主，其中全面性强直-阵挛性发作者占93.3%；仅有9.3%的患者长程 脑电图记录到痫性放电；头部MRI均未见明显结构异常。2组性别、发病年龄、发作前打麻将时长、发作类型及头部 MRI改变等方面比较，差异均无统计学意义(均P>0.05)。结论：精神疲劳和认知负荷过重是导致麻将反射性癫痫发作 的可能机制。

Clinical features of mah-jong reflex epilepsy

Objective: To analyze clinical features of mah-jong refl ex epilepsy, and to explore the underlying mechanisms. Methods: Th e clinical data of 15 patient (a study group), who visited in the outpatient department in the Third Xiangya Hospital, Central South University from 2016 to 2018, were collected and analyzed. The clinical data included disease history, 24 h- electroencephalography (EEG) and magnetic resonance imaging (MRI) scan. Next, previous 84 case (a literature group) reports published in the past 20 years were searched and compared. Results: Both groups of mah-jong reflex epilepsy were predominant in middle-aged men, with onset ages of (44.53±10.58) and (41.48±17.85) years old, respectively. In the study group, time interval usually lasted (4.00±2.45) h from starting play mah-jong to seizure att ack, 73.3% patients complained mental fatigue before seizure att ack, and 93.3% of the patients were described to have general tonic-clonic seizure. Few positive result was discovered in auxiliary examination, and the percentage was 9.3% in EEG, while no positive outcome was seen in head MRI. There were nosignificant differences in gender, age of onset, duration of playing mah-jong before attack, type of attack, and changes of head MRI between the 2 groups (all P>0.05). Conclusion: Mental fatigue after long-time mah-jong playing and cognitive dysfunction might be the potential triggers in mah-jong reflex epilepsy.