【癫痫伴裂脑畸形患者的临床与功能障碍】。

V I Guzeva, I V Okhrim, O V Guzeva, V V Guzeva, V R Kasumov
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引用次数: 0

摘要

目的:通过临床、电生理和神经影像学结果分析,探讨分裂性脑畸形(schizencephaly, SE)儿童结构性癫痫的诊断和预测特点。材料与方法:对15例癫痫合并SE患者(男7例,女8例)进行检查,年龄3个月~ 14岁。结果:单侧SE 10例(闭式SE 4例,开式SE 6例),双侧开放性SE 5例。异常的主要定位在额区。在100%的病例中,检测到不同程度的认知和运动障碍。在研究组中,11例(73.3%)患者在6岁前被诊断为癫痫。SE患儿癫痫的临床表现包括局灶性癫痫发作10例(73.3%),癫痫性痉挛3例(20.0%),局灶性癫痫发作继发泛化5例(33.3%),失张力性癫痫1例(6.7%)。26.7%的SE患儿有难治性癫痫,40%的患儿脑电图无阳性变化。结论:SE癫痫患者脑结构损伤程度与认知和运动障碍程度相关。癫痫的形式、癫痫发作的符号学和抗癫痫治疗的有效性不取决于SE的类型,而是与皮质障碍的程度相关。
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[Clinical and functional disturbances in epilepsy patients with schizencephaly].

Objective: To study the features of diagnosing and predicting structural epilepsy in children with schizencephaly (SE) based on the analysis of clinical, electrophysiological and neuroimaging results.

Material and methods: Fifteen patients with epilepsy and SE (seven boys and eight girls), aged from 3 months to 14 years, were examined.

Results: Unilateral SE was detected in ten patients (closed - in four, open - in six), bilateral open SE was detected in five patients. The predominant localization of the anomaly is in the frontal region. In 100% of cases, cognitive and motor impairments of varying severity were detected. In the study group, 11 patients (73.3%) were diagnosed with epilepsy before the age of 6 years. The clinical presentations of epilepsy in children with SE included focal seizures in ten patients (73.3%), epileptic spasms in three patients (20.0%), focal seizures with secondary generalization in five (33.3%), atonic - in one child (6.7%). Refractory epilepsy was noted in 26.7% children with SE, and the absence of positive electroencephalographic changes in 40% of children.

Conclusions: The extent of structural brain damage in SE in patients with epilepsy correlates with the degree of cognitive and motor deficits. The form of epilepsy, the semiotics of epileptic seizures, and the effectiveness of antiepileptic therapy do not depend on the type of SE, but correlate with the extent of cortical disorders.

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Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova
Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova Medicine-Psychiatry and Mental Health
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