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目的儿童失神癫痫(Childhood absence epilepsy,CAE)是儿童期起病的一种最常见的癫痫综合征。国际抗癫痫联盟(International League Against Epilepsy,ILAE)于1989年及2005年先后提出2种“儿童失神癫痫诊断标准”。文中探讨了2种诊断标准的差异及其临床意义。方法将符合2种诊断标准与仅符合2005年诊断标准的CAE患儿分为2组:ILAE1989年诊断标准组(A组)患儿16例;ILAE 2005年诊断标准组(B组)患儿10例,对2组CAE患儿的临床及脑电图(electroen-cephalogram,EEG)等特征进行比较。结果与1989年诊断标准比较,2005年诊断标准更为严谨,条款内容更具体,符合1989年诊断标准的16例患儿中,仅10例符合2005年诊断标准。与A组患儿比较,B组患儿EEG全导联3 Hz棘慢波发放持续时程长,EEG诱发试验阳性率和单药控制率更高。结论 ILAE 2005年CAE诊断标准能保证CAE患者的同质性,更有利于药物选择、治疗及预后的评估。
Purpose Childhood absence epilepsy (CAE) is one of the most common epilepsy syndromes of childhood onset. International League Against Epilepsy (ILAE) in 1989 and 2005 have proposed two kinds of “children without epilepsy diagnostic criteria ”. The paper discusses the differences between the two diagnostic criteria and their clinical significance. Methods A total of 16 children with CAE who met the diagnostic criteria of 2005 and 2005 were divided into two groups: 16 children in the diagnostic criteria group (group A) of ILAE in 1989, 10 children in the ILAE 2005 diagnostic criteria group (group B) Cases, clinical and electroencephalogram (EEG) and other characteristics of two groups of CAE children were compared. Results Compared with the diagnostic criteria in 1989, the diagnostic criteria in 2005 were more rigorous and the terms were more specific. Of the 16 children who met the diagnostic criteria of 1989, only 10 patients met the diagnostic criteria of 2005. Compared with group A, children in group B had longer sustained duration of spike and slow wave delivery at 3 Hz, and higher positive rates of EEG induction and single drug control. Conclusion ILAE 2005 CAE diagnostic criteria to ensure the homogeneity of CAE patients, but also more conducive to drug selection, treatment and prognosis assessment.