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目的探讨婴儿痉挛(IS)患儿一次发作事件中部分性发作(PS)和痉挛发作(ES)共存的现象(PS-ES)。方法2002年2月至2006年4月北京大学第一医院收治的IS患儿,对存在PS-ES现象的14例进行分析。结果14例中男9例,女5例。癫起病年龄为生后1d至2岁,监测到PS-ES现象的时间为生后1个月至2.9岁。PS-ES发作可为PS后紧跟ES,ES后紧跟PS,成串ES中混有PS。起病的惊厥类型分别有PS、ES及PS和ES同时起病,与PS-ES的组合方式无特定的相关性。PS-ES现象中的PS发作多起源于中央、顶区。半数以上患儿有病因和(或)影像学异常。经治疗的11例中5例短期有明显的临床和EEG改善,但仅3例得到了较长时间的控制。随访11例患儿发现智力运动发育均落后。结论一次发作性事件中PS和ES可以不同的顺序组合出现,与起病时首发惊厥类型无特定的相关性。具有PS-ES现象的IS患儿可存在多种病因,且多数患儿治疗反应差及预后不良。
Objective To investigate the coexistence of partial seizures (PS) and spastic seizures (ES) in one episode of infantile spasm (IS). Methods From January 2002 to April 2006, 14 children with IS who were admitted to Peking University First Hospital were enrolled in this study. Results Among the 14 cases, 9 were males and 5 were females. Epilepsy onset age of 1d to 2 years after birth, monitoring of PS-ES phenomenon time from 1 month to 2.9 years old. PS-ES episodes can be followed by PS followed by ES, ES followed by PS, mixed with PS in series ES. The onset of seizure type PS, ES and PS and ES both onset, and PS-ES combination of no specific relevance. PS-ES phenomenon in the PS attack originated in the central and top area. More than half of children with etiology and / or imaging abnormalities. Of the 11 treated patients, 5 had short-term clinical and EEG improvements, but only 3 received longer control. Eleven children were followed up for mental retardation. Conclusions PS and ES may occur in different sequential combinations in a paroxysmal event, with no specific association with the onset of seizure type. IS children with PS-ES phenomenon may exist a variety of causes, and most children with poor response and poor prognosis.