摘要
目的总结神经元移行障碍性疾病致癫痫患儿的临床特征。方法回顾性分析25例神经元移行障碍性疾病致癫痫患儿的临床资料,包括临床特点,癫痫发作类型,脑电图、头颅MRI表现,药物疗效及转归等。结果 25例患儿癫痫呈强直-阵挛发作2例,强直发作1例,阵挛发作1例,局灶性发作18例,局灶性发作伴泛化1例,痉挛发作2例;脑电图正常5例,背景节律异常1例,癫痫样放电波19例;头颅MRI示灰质移位13例,额颞白质内灰质移位合并脑裂畸形1例,单纯脑裂畸形1例,局部皮质发育不良9例,脑穿通畸形1例;单药治疗6例中发作控制2例,有效1例,无明显减轻3例;2种药物联合治疗11例中发作控制3例,有效5例,3例无明显减轻;3种药物联合治疗8例中发作控制2例,显效2例,有效1例,无明显减轻3例。结论神经元移形障碍性疾病致癫痫患儿癫痫主要为局灶性发作,脑电图主要呈癫痫样放电波,头颅MRI多见灰质移位及局部皮质发育不良,单药抗癫痫治疗效果不佳,需2种及以上药物治疗。
Objective To explore the clinical features of epilepsy induced by neuronal migration disorders in children.Methods The clinical data of epilepsy induced by neuronal migration disorders in 25 children were retrospectively analyzed,including clinical features,seizure types,electroencephalogram（EEG）,brain MRI,drug efficacy and outcome.Results Seizure types of these 25 children included 2 cases of tonic-clonic seizures,1 of tonic seizures,1 of clonic seizures,18 of focal seizures,1 of secondarily generalised seizures,and 2 of epileptic spasms.EEG showed normal in 5 cases,abnormal background rhythm in 1 and epileptic discharge in 19.Brain MRI showed gray matter heterotopia in 13 cases,gray matter heterotopia complicated with schizencephaly in 1 case,schizencephaly in 1 case,focal cortical dysplasia in 9,and porencephaly in 1 case.The results of single anti-epileptic drug in 6 cases showed controlled seizures in 2,effective in 1,and no effective in 3.The results of two anti-epileptic drugs in 11 cases showed controlled seizures in 3,effective in 5 and no effective in 3.The results of three anti-epileptic drugs in 8 cases showed controlled seizures in 2,obviously effective in 2,effective in 1 and no effective in 3.Conclusion The main type of epilepsy complicated with neuronal migration disorders is focal seizures,and EEG shows epileptic discharge.Brain MRI mainly shows gray matter heterotopia and local cortical dysplasia.The combined two or more anti-epileptic drugs is superior to single anti-epileptic drug.
作者
李婷婷
高丽
LI Tingting;GAO Li(Department of Paediatrics,Henan Provinical People＇s Hospital,People＇s Hospital of Zhengzhou University,Zhengzhou 450003,China)
出处
《中华实用诊断与治疗杂志》
2018年第11期1084-1086,共3页
Journal of Chinese Practical Diagnosis and Therapy
基金
河南省医学科技攻关计划重点项目(201502023)
关键词
神经元移行障碍
癫痫
灰质移位
局部皮质发育不良
neuronal migration disorders
epilepsy
gray matter heterotopia
local cortical dysplasia
