上海交通大学学报（医学版）

›› 2010, Vol. 30 ›› Issue (2): 140-.

• 专题报道（儿科学研究） • 上一篇    下一篇

儿童癫癎伴枕叶癇样放电临床分析

葛 欣, 吴 洁   

  1. 上海交通大学 医学院新华医院小儿神经内科, 上海 200092
  • 出版日期:2010-02-25 发布日期:2010-02-25
  • 通讯作者: 吴 洁, 电子信箱: wujie_xhyy@126.com。
  • 作者简介:葛 欣（1977—）, 男, 主治医师, 硕士；电子信箱: gexinn@126.com。

Clinical analysis of childhood epilepsy with occipital paroxysms

GE Xin, WU Jie   

  1. Department of Pediatric Neurology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200092, China
  • Online:2010-02-25 Published:2010-02-25

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摘要：

目的 分析儿童癫癎伴枕叶癎样放电病例临床特点的差异，提高对儿童枕叶样放电的认识和诊断水平。方法 对38例显示发作间期的棘波和（或）尖波出现在枕区、后颞-顶区的患儿的病例资料进行了回顾性分析，运用χ2检验或Mann-Whitney U检验，对流行病学数据、发作时症状、脑电图、神经影像学资料、治疗反应和预后进行比较。结果 特发性组有4例有神经系统疾病的家族史，且癫癎发作次数明显少于症状性组，两组都表现有自主神经症状，但在Panayiotopoulos型的患儿中发作性呕吐及眼球偏视更常见。特发性组的预后明显优于症状性组(P<0.05)。结论 Panayiotopoulos综合征更为常见，神经病学的缺陷和脑电图的特点是预测儿童枕叶癫癎能否缓解的主要因素。通常具有较好的预后。

关键词: 枕叶放电, Panayiotopoulos型, Gastaut型, 儿童

Abstract:

Objective To analyse the differences between idiopathic and symptomatic childhood epilepsy with occipital paroxysms. Methods The medical records of 38 patients with interictal spikes and/or sharp waves over occipital areas, posterior temporal-parietal areas, or both were retrospectively analysed. Epidemiological data, ictal symptoms, electroencephalogram, neuroimaging studies, treatment response and prognosis were compared using chi-square test or Mann-Whitney U test. Results Four patients of  idiopathic group had positive family history related to nervous system. Seizures were more frequent in symptomatic group than in idiopathic group. Both groups showed autonomic symptoms, while ictal vomiting and deviation of eyes were more common in the presence of Panayiotopoulos type. The prognosis of idiopathic group was much better than that of symptomatic group. Conclusion Panayiotopoulos syndrome is more common. Neurologic deficits and electroencephalographic characteristics are major factors to predict seizure remission in children with occipital lobe epilepsy. Idiopathic childhood epilepsy with occipital paroxysms may result in better prognosis.

Key words: occipital paroxysms, Panayiotopoulos type, Gastaut type, childhood