论文部分内容阅读
目的探讨难治性癫痫(RE)的临床特点。方法2006年1月至2008年12月在复旦大学附属儿科医院癫痫中心收集登记的400例癫痫患儿中随访,对其中83例RE患儿的临床资料进行回顾性分析和前瞻性随访观察。采用国际抗癫痫联盟指南对癫痫及癫痫综合征进行诊断与分类。结果平均随访(1.17±0.09)年,83例RE患儿中,症状性癫痫64例(77.1%),1岁之前发病43例(51.8%),频繁发作(发作至少1次/周)61例(73.5%),43例(51.8%)出现多种癫痫发作形式,并发智力障碍者74例(89.2%);影像学异常改变37例(44.6%),脑电图背景活动变慢26例(21.3%),局灶放电18例(21.7%);应用3种药物的比例达50.6%(42例),应用4种药物者达7.2%(6例)。结论RE患儿具有如下特点:发病年龄早、病初发作频繁、症状性癫痫多、伴发或继发精神运动发育迟缓,影像学异常改变、脑电图背景活动异常、应用多种抗癫痫药物疗效差。
Objective To investigate the clinical features of refractory epilepsy (RE). Methods From January 2006 to December 2008, 400 cases of epilepsy were enrolled in the Epilepsy Center of Pediatric Hospital affiliated to Fudan University. The clinical data of 83 children with RE were retrospectively analyzed and prospectively followed up. Using the international antiepileptic alliance guidelines for epilepsy and epilepsy syndrome diagnosis and classification. Results The average follow-up (1.17 ± 0.09) years was 83 cases of RE children, with 64 cases (77.1%) of symptomatic epilepsy, 43 cases (51.8%) before 1 year old and 61 cases of frequent episodes (73.5%), 43 cases (51.8%) had multiple forms of epilepsy and 74 cases (89.2%) had mental retardation. Imaging abnormalities changed in 37 cases (44.6%) and EEG background activity decreased in 26 cases 21.3%) and focal discharges in 18 (21.7%) patients. Forty patients (42%) received three drugs and 7.2% (Four patients) received four drugs. Conclusion Children with RE have the following characteristics: early onset of disease, frequent episodes of early illness, multiple symptoms of epilepsy, concomitant or secondary mental retardation, abnormal imaging changes, abnormal EEG background activity, the application of a variety of antiepileptic drugs Poor efficacy.