儿童额叶癫(癎)的临床与脑电图特征

目的 总结儿童额叶癫癇(FLE)的临床表现、脑电图(EEG)特征和预后.方法 对28例FEE患儿的临床资料进行回顾性分析.结果 起病年龄21个月～17岁,癫癇发作表现:躯体运动性自动症20例,偏转性强直18例,姿势性强直19例,植物神经症状10例,局部阵挛11例,发声9例,额叶失神3例,简单自动症3例,感觉异常1例,发笑发作1例.头颅影像学异常13例,长时间视频脑电图(V-EEG)检查78.6%(22/28例)记录到疴样放电,67.9%(19/28例)记录到临床发作.26例额叶癫癇随访1～6年,抗癫癇药物治疗效果良好15例.结论 额叶癫癇是一组具有特征性的癫癇综合征,V-EEG是临床无创伤性诊断额叶癫癇最佳方法,口服抗癫癇药物疗效良好.

The clinical and EEG characteristics in childhood frontal lobe seizures

Objectives To summarize the relationship between clinical characteristics, electroencephalogram(EEG)features and prognosis in childhood frontal lobe epilepsy(FLE). Methods The clinical data of 28 children with frontal lobe epilepsy were reviewed retrospectively. Results The onset age of epileptic was from 21 months to 17 years old. Manifestations of seizures were various,including hypermotor automatisms(20),torsive movements(18),asymmetric tonic seizures(19),vegetative seizures(10),focal clonic seizures(11),vocalization(9),frontal absences(3),automatisms(3),focal sensory seizures(1),gelastic seizures(1). Head magnetic resonance image were abnormal in 13 cases. The vigilance-controlled electroencephalogram(V-EEG)recorded interictal epilepsy discharges in 22 cases (78.6%),and recorded seizure attack in 19 patients(67.9%). Twenty-six patients were followed up 1 to 6 years. Fifteen patients were seizure free after the anti-epileptic drug treatment. Conclusions FLE is an epileptic syndrome with its own distinct characteristics. V-EEG is the best diagnostic method with no traumatic effects. Oral administration of anti-epileptic drug is the effective treatment.