复杂部分性癫痫持续状态的临床与脑电图特征

The Clinical and EEG Characteristics of Complex Partial Status Epilepticus in Children

摘要:

目的 通过对复杂部分性癫痫持续状态 (CPSE)的临床分析 ,阐述小儿CPSE的临床特征、诊断与治疗。方法 对该院 1 7例CPSE患儿的临床过程、脑电图及抗癫痫治疗等资料进行分析。结果 1 7例CPSE患儿起病年龄为 3～ 1 2岁 ,临床发作持续时间为 1h～ 3.5周 ;78%的患儿有明确的病因 ,CPSE临床表现多样 ,所有病例均有意识障碍 ,同时伴有不同程度的精神和行为异常 ,发作期脑电图主要以基本电活动变慢伴颞部局灶性慢波或痫样放电的持续或周期性发放为特征 ,经抗癫痫药物等治疗 ,1 1例患儿持续发作完全控制 ,4例持续状态控制 ,仅有部分性发作 ,2例未能控制。结论 意识障碍伴精神和行为异常为CPSE的临床特征 ,发作期及发作间期脑电图检查可明确诊断 ,对CPSE患儿应予以及时诊断和处理。

Abstract:

Objective To clarify the clinical feature of complex partial status epilepticus (CPSE) in children. Methods The clinical and EEG manifestations and the treatment with antiepileptic drugs in 17 patients suffering from CPSE were analyzed. Results The age of the onset of symptoms ranged from 3 to 12 years. The clinical attacks lasted a variable time from 1 hour to more than 3 weeks. Definite medical causes were identified in 78% of the patients. Each patient had a prolonged change of consciousness, accompanied by psychological and behavioral changes. The characteristics of ictal EEG in CPSE patients generally included slow activity and δ or θ activity in the temporal region. After antiepileptic drug treatment, the conditions of 11 patients were under complete control, 4 patients had no CPSE but complex partial seizures, and 2 patients had no improvement. Conclusions CPSE may present with confusion, behavioral disturbances and psychiatric conditions. The diagnosis can be made by the ictal or interictal EEG. It is necessary to make the diagnosis and control the seizures as early as possible.