儿童枕叶癫痫的临床、影像学及脑电图特点分析

目的总结儿童枕叶癫痫（COE）的临床、影像学、脑电图特点。方法对41例COE患儿的临床资料进行回顾性分析。结果本组中19例为特发性枕叶癫痫,22例为症状性枕叶癫痫。临床表现：眼球偏转21例,头偏转11例,头痛20例,呕吐15例,视幻觉18例,黑朦10例,眼球阵挛7例,眼睑扑动7例,跌倒发作3例,继发单侧阵挛9例,继发全身阵挛14例。头颅影像学异常19例。脑电图：发作间期痫样放电38例,发作期痫样放电9例。结论 COE发作的临床表现主要为视觉及运动症状;影像学检查可鉴别特发性COE和症状性COE;发作间期EEG痫样放电多见,主要放电部位是后头部。

The analysis of clinical characteristics,imaging examination,and electroencephalogram on childhood occipital epilepsy.

Objective To summarize the clinical features,imaging examination,electroencephalogram and outcome of childhood occipital epilepsy（COE）.Methods Clinical data of 41 children with COE were retrospectively reviewed.Results Of the 41 children with COE,nineteen（19） out of 41 patients diagnosed as idiopathic COE,the other 22 of 41 patients were diagnosed as symptomatic COE.Seizure manifestations were various including eye deviation（21）,head deviation（11）,headache（20）,ictal vomiting（15）,visual hallucination（18）,visual loss（10）,nystagums（7）,eyelid twitching（7）,drop attack（3）,secondary hemiconvulsions（9）,and generalized convulsions（14）.Abnormal brain imaging findings were seen in 19 cases.The interictal EEG discharges were seen in 38 cases.EEG was recorded in 9 patients during seizure attack.Conclusion The main clinical seizure characteristics of COE were motor and visual symptoms.The discrimination of idiopathic COE and symptomatic COE could depend on imaging examination.The interictal EEG discharges were found in most patients with COE,the main discharge part is hind head.