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目的分析青少年肌阵挛性癫的临床及治疗特点。方法对87例青少年肌阵挛性癫患者进行回顾性分析,包括家族史、热性惊厥史、发病规律、临床表现、脑电图、变化及治疗效果。结果10例(11.5%)患者亲属中有癫史,12例(13.8%)患者有热性惊厥。肌阵挛发作起病年龄(13.1±3.4)岁;伴发强直阵挛发作平均起病年龄(14.3±3.8)岁;伴失神发作平均起病年龄(10.0±3.3)岁。平均延误诊断时间2.2年。睡眠诱发、闪光诱发刺激脑电图检查可提高性放电检出阳性率。16例患者在抗癫治疗中出现了癫发作次数或强度的增加。给予丙戊酸钠单药治疗的45例(75%)患者癫发作可得到控制。结论临床工作中对该病认识不足,极易误诊,造成疾病治疗迁延不愈,甚至出现治疗中因抗癫药物选择不合理而引起癫发作增加;小剂量丙戊酸钠治疗有效。
Objective To analyze the clinical and therapeutic characteristics of myoclonic epilepsy in adolescents. Methods A total of 87 adolescents with myoclonic epilepsy were retrospectively analyzed, including family history, history of febrile seizures, incidence, clinical manifestation, electroencephalogram, changes and therapeutic effects. Results Ten patients (11.5%) had a history of epilepsy in their relatives and 12 (13.8%) had febrile seizures. The age of onset of myoclonic episode was (13.1 ± 3.4) years; the mean age of onset was 14.3 ± 3.8 years with associated tonic clonic seizures; and the mean age of onset of absence seizures was 10.0 ± 3.3 years. The average delay diagnosis time 2.2 years. Sleep-induced flash-evoked stimulation of electroencephalography can improve the positive rate of popliteal discharge detection. Sixteen patients experienced an increase in the number or intensity of epileptic seizures in antiepileptic treatment. Epileptic seizures were controlled in 45 (75%) patients given sodium valproate monotherapy. Conclusion Clinical knowledge of the disease is inadequate, and it is easily misdiagnosed, resulting in delayed healing of the disease. Even the emergence of epileptic seizures increased due to the unreasonable choice of antiepileptic drugs. Small doses of sodium valproate are effective.