论文部分内容阅读
目的探讨表现为过度运动发作(HMS)的儿童部分性癫痫的临床特征。方法对2003年6月至2009年1月首都儿科研究所神经科门诊或病房符合诊断标准的7例患儿进行发作期及发作间期视频脑电图监测,观察临床发作症状及发作期、发作间期脑电图表现,并追踪抗癫痫药物疗效。结果 7例患儿视频脑电图共记录到29次发作,持续时间10～84s,22次发生于睡眠,7次发生于清醒。发作时均有程度不同的躁动不安,过度运动行为表现多样,包括拍手、挥舞、挥拳、拍打、抓物、蹬踏、蹦跳等上、下肢动作,髋部水平移动,由平卧欲坐起动作,过度运动以外动作包括眼、头颈、躯干向一侧扭转、姿势性强直、表情恐惧或愤怒、面部涨红等。发作间期脑电图,除1例未见异常波形外,余6例均可见异常波形,表现为双侧或一侧额、额极导联棘波、尖波;7例发作期脑电图均为单或双侧额极、额起源的低幅快波节律,继而被大量动作伪迹掩盖,发作后渐恢复原背景。结论 HMS是部分性癫痫的一种发作形式,发作时以明显躁动的过度运动为特征,可伴有不对称强直姿势及表情变化,发作期脑电图均表现为单或双侧额极、额导联起源的低幅快波节律,卡马西平或奥卡西平有效,多数患儿可达到满意效果。
Objective To investigate the clinical features of partial partial epilepsy in children with hyperactivity disorder (HMS). Methods From June 2003 to January 2009, seven children with neurological outpatient department or ward in line with diagnostic criteria of Capital Institute of Pediatrics were monitored by video EEG during and after seizure. The clinical symptoms, seizures and seizures were observed. Interphase EEG performance and follow-up of anti-epileptic drugs. Results A total of 29 episodes of video-EEG were recorded in 7 children with a duration of 10-84 s, 22 episodes of sleep, and 7 episodes of soberness. There are varying degrees of restlessness at the onset, excessive performance of various sports activities, including clapping, waving, fist, beating, grasping, pedal, bouncing and other lower limb movements, horizontal hip movement, from the horizontal to sit Actions, Excessive movement Other actions include the eyes, head and neck, torso torsion to the side, straightness, facial expressions, fear or anger, facial flushing and so on. Seizure interval EEG, except one case without abnormal waveforms, more than 6 cases were seen abnormal waveforms, manifested as bilateral or one side of the frontal, frontal pole spikes, spikes; 7 cases of attack EEG Both single-sided or bilateral frontal, frontal origin of the low-rate fast-wave rhythm, and then a large number of motion artifacts to cover, recovery gradually recover the background. Conclusions HMS is a kind of seizure of partial epilepsy. It is characterized by excessive agitation with obvious agitation. It may be accompanied by asymmetrical straightness posture and facial expression changes. EEG is characterized by single or bilateral frontal extremity during epileptic period Low-amplitude fast wave rhythm of lead origin, carbamazepine or oxcarbazepine effective, most children can achieve satisfactory results.