遗传畸形综合征脑电图和癫痫发作类型的评估:附50例报告并文献复习

G. Gürbüz, F. Hazan, S. Edizer, Bahar Baysal, Ünsal Yılmaz, A. Ünalp
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摘要

许多染色体异常表现为癫痫。只有少数典型的脑电图和癫痫类型已确定在遗传综合征。某些遗传综合征的典型癫痫发作和脑电图结果的识别可以作为遗传分析的指导。本研究旨在寻找特定遗传综合征的典型脑电图模式。该研究招募了2014-2017年间在Dr. behet UZ儿童医院儿科神经病学和医学遗传学部门诊断为癫痫和遗传综合征的50名0-16岁患者。患者的特征和畸形特征从医学遗传门诊患者档案中检索,而癫痫类型、癫痫综合征分类、脑电图和脑MRI结果、发病年龄和癫痫发作频率则从儿童神经病学随访中确定。50例患者(29例女性)平均年龄为6.52±3.67岁(max=16, min=1)。微缺失重复22例(44%),染色体异常12例(24%),单基因综合征16例(32%)。40例(80%)患者脑电图有病理表现。28例(56%)为局灶性癫痫障碍,7例(14%)为癫痫性脑病,5例(10%)为全身性癫痫障碍。确定每种遗传畸形综合征特有的癫痫发作类型和脑电图模式可为临床医生识别这些综合征提供线索。然而,为了检测其他特定的脑电图模式,需要对更多患者进行多中心研究。
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Evaluation of Eeg Pattern and Seizure Types of Genetic Dysmorphic Syndromes: Report of 50 Patients and Review of the Literature
Many chromosomal anomalies manifest with epilepsy. Only few typical EEG and seizure type have been identified in genetic syndromes. Identification of typical seizure and EEG findings of certain genetic syndromes may serve as a guide for genetic analysis. This study aims to find typical EEG paterns of spesific genetic syndromes. The study enrolled 50 patients aged 0-16 years with a diagnosis of epilepsy and genetic syndrome in between 2014-2017 at the Dr. Behçet UZ Children’s Hospital Pediatric Neurology and Medical Genetics departments. Patients' characteristics and dysmorphic features were retrieved from Medical Genetic outpatient clinic patient files, while seizure type, epileptic syndromic classification, EEG and brain MRI findings, age at onset and frequency of seizure were determined from pediatric neurology follow-ups. Fifty patients (29 girls) with a mean age of 6.52 ±3.67 years (max=16, min=1) were enrolled. Twenty-two patients had microdeletion-duplication (44%), 12 had chromosomal anomalies (24%) and 16 had monogenic syndrome (32%). Pathology was present in the EEGs of 40 patients (80%). Focal epileptic disorder was determined in 28 subjects (56%), epileptic encephalopathy in 7 (14%), and generalized epileptic disorder in 5 (10%) Identification of seizure type and EEG pattern specific to each genetic dysmorphic syndrome may give clues to clinicians in recognizing these syndromes. However, in order to detect other specific EEG patterns, there is a need for multicentre studies with more patients.
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