伴有非癫癎发作的322例脑性瘫痪临床分析

朱登纳, 王军, 贾延劼, 牛国辉, 孙莉, 熊华春, 翟红印, 陈海, 李林琛

中国当代儿科杂志 ›› 2010, Vol. 12 ›› Issue (12) : 933-935.

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中国当代儿科杂志 ›› 2010, Vol. 12 ›› Issue (12) : 933-935.
论著·临床研究

伴有非癫癎发作的322例脑性瘫痪临床分析

  • 朱登纳,王军,贾延劼,牛国辉,孙莉,熊华春,翟红印,陈海,李林琛
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Clinical analysis of 322 cases of non-epileptic cerebral palsy

  • ZHU Deng-Na, WANG Jun, JIA Yan-Jie, NIU Guo-Hui, SUN Li, XIONG Hua-Chun, ZHAI Hong-Yin, CHEN Hai, LI Lin-Chen
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摘要

目的:了解伴有非癫癎发作的脑性瘫痪(脑瘫)的临床特点,以提高与癫癎发作的鉴别能力。方法:1 198例9个月至6岁的脑瘫患儿纳入研究,对伴随发作性症状的患儿进行24 h视频脑电图监测,明确伴随的发作是否为癫癎发作,并观察伴随非癫癎发作患儿的发作症状、年龄、脑瘫型别及脑电图特征。结果:共578例(48.24%)患儿伴随发作性症状,其中伴随癫癎发作者231例(19.28%),非癫癎发作322例(26.88%)。322例伴随非癫癎发作的脑瘫患儿中,发作性症状包括非癫癎性强直发作、发作性摇头、耸肩或头后仰、发作性哭闹、惊恐发作、睡眠肌阵挛、刻板性运动等;158例(49.1%)显示脑电图有非特异性异常;111例(34.5%)在基层医院误诊为癫癎;1岁以内患儿非癫癎发作频率高于1岁~和3~6岁组患儿;痉挛型脑瘫患儿非癫癎发作频率最高(168例,52.2%),其次为不随意运动型(69例,21.4%)和混合型(65例,20.2%)。结论:脑瘫患儿伴随的发作性症状部分为非癫癎发作,注意与癫癎发作相鉴别。非癫癎发作发生频率与患儿年龄及脑瘫型别有一定关系。[中国当代儿科杂志,2010,12(12):933-935]

Abstract

OBJECTIVE: To study the clinical features of non-epileptic seizures associated with cerebral palsy (CP) in children. METHODS: A total of 1 198 children with CP (age: 9 months to 6 years) were enrolled. The children with paroxysmal events were monitored by 24 hrs video-EEG (VEEG) to make sure the seizures were epileptic or non-epileptic. The symptoms, age, CP types and EEG features were observed in children with non-epileptic CP. RESULTS: Five hundred and seventy-eight children (48.24%) presented paroxysmal events. The seizures were epileptic in 231 children (19.28%) and non-epileptic in 322 cases (26.88%). In the 322 cases of non-epileptic CP, the paroxysmal events were of various kinds, including non-epileptic seizure tonic, seizure shake head, shrug shoulder or head hypsokinesis, cry or scream, panic attacks, sleep myoclonic and stereotyped movement. One hundred and fifty-eight (49.1%) out of the 322 children demonstrated nonspecific EEG abnormalities. One hundred and eleven children (34.5%) were misdiagnosed as epilepsy in primary hospitals. The CP children less than one year old showed higher frequency of non-epileptic seizures than the age groups over 1 year and 3 to 6 years. The frequency of nonepileptic seizures was the highest in children with spastic CP (168 cases, 52.2%), followed by dyskinetic CP (69 cases, 21.4%) and mixed type CP (65 cases, 20.2%). CONCLUSIONS: The paroxysmal events in children with CP partially are non-epileptic seizures and it is important to differentiate non-epileptic from epileptic seizures. The frequencies of non-epileptic seizures may be associated with a child’s age and CP type.[Chin J Contemp Pediatr, 2010, 12 (12):933-935]

关键词

脑性瘫痪 / 非癫癎发作 / 癫癎 / 儿童

Key words

Cerebral palsy / Non-epileptic seizure / Epilepsy / Child

引用本文

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朱登纳, 王军, 贾延劼, 牛国辉, 孙莉, 熊华春, 翟红印, 陈海, 李林琛. 伴有非癫癎发作的322例脑性瘫痪临床分析[J]. 中国当代儿科杂志. 2010, 12(12): 933-935
ZHU Deng-Na, WANG Jun, JIA Yan-Jie, NIU Guo-Hui, SUN Li, XIONG Hua-Chun, ZHAI Hong-Yin, CHEN Hai, LI Lin-Chen. Clinical analysis of 322 cases of non-epileptic cerebral palsy[J]. Chinese Journal of Contemporary Pediatrics. 2010, 12(12): 933-935
中图分类号: R742.3   

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