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目的探讨儿童眼睑肌阵挛非惊厥性癫痫持续状态(Eyelid myoclonia-nonconvulsive status epilepticus,EM-NCSE)的临床和脑电图特点、治疗以及预后。方法收集2015年1月-2016年8月在山东大学齐鲁儿童医院神经科诊治的3例EM-NCSE患儿的临床和视频脑电图(VEEG)资料,以及对抗癫痫药物(AEDs)治疗反应进行观察分析。结果 3例患儿中女2例,男1例。发病年龄6~10岁,平均8.67岁。发作时临床表现为精神错乱、烦躁不安、挤眉弄眼、眼球频繁向上滚动等,VEEG示广泛性3~6 Hz棘慢综合波或多棘慢综合波,以前额、额、前颞为著,闪光刺激后可见患儿眼睑节律性眨动。结论 EM-NCSE由于其发作时症状复杂多样不易发现,常导致漏诊、误诊,详细询问病史并及时进行VEEG检查以及进行诊断性用药对确诊具有极其重要价值;地西泮能够有效改善发作时临床表现和VEEG特征,AEDs疗效较好。
Objective To investigate the clinical and electroencephalographic features, treatment and prognosis of eyelid myoclonia-nonconvulsive status epilepticus (EM-NCSE) in children. Methods The clinical and video EEG data of 3 EM-NCSE children diagnosed and treated in Department of Neurology, Qilu Children’s Hospital of Shandong University from January 2015 to August 2016 were collected, and the response to treatment with antiepileptic drugs (AEDs) Observation and analysis. Results 3 cases of children in 2 women, 1 male. The age of onset of 6 to 10 years old, with an average of 8.67 years old. The onset of clinical manifestations of delirium, irritability, wink, eye frequently scroll up and so on, VEEG showed extensive 3 ~ 6 Hz spike and slow synthesis of waves or more spine and slow waves, with forehead, forehead, flash stimulation After the rhythm of children with eyelid rhythm can be seen. Conclusions EM-NCSE is not easy to find due to complicated and diverse symptoms during the onset of EM-NCSE. It often leads to missed diagnosis, misdiagnosis, detailed medical history, prompt VEEG examination and diagnostic medication. Diagnosed with diazepam can effectively improve clinical manifestations And VEEG features, AEDs better curative effect.