【摘要】 目的　研究婴儿良性癫的发作特征、脑电图及治疗反应 ,探讨早期诊断方法。方法　对出生后 3～ 2 4个月内起病 ,排除热性惊厥、症状性癫及发育异常的婴儿惊厥进行临床观察及录像脑电图 (VEEG )监测 ,并随访治疗效果和远期预后。结果　 42例经 2年以上随访确诊为婴儿良性癫。其中 3例有良性婴儿惊厥家族史 ,19%惊厥伴有轻微腹泻 ,67%为短期内频繁发作 ,无癫持续状态。 3例VEEG监测证实分别为起源于颞区、枕区及多灶性的部分性发作。发作间期脑电图背景正常 ,2 4%睡眠中有Rolandic区小棘波。 3 9例接受抗癫单药治疗 ,平均用药时间 9个月 ,3例未用药物治疗 ,起病 1年内发作均消失。结论　起病早期具有以下特征应考虑有婴儿良性癫的可能 :①起病年龄在 3～ 12个月 ,不超过 2 4个月 ,可有婴儿良性惊厥家族史 ;②发病前后精神运动发育正常 ;③发作无诱因 ,或仅有轻度腹泻等非特异性感染 ;④以部分性发作为主 ,可继发全身性发作 ,起病时发作可以很频繁 ,但无癫持续状态 ;⑤发作间期脑电图背景正常 ,无典型癫样放电 ,可有睡眠期Rolandic区小棘波 ;⑥神经影像学正常更多还原

【Abstract】 Objective To investigate clinical characteristics, EEG changes and therapeutic response of benign infantile epilepsy and to study the early diagnostic methods. Methods Clinical observation and Video-EEG monitoring were carried out in babies with convulsions at 3-24 months of age. In these children, febrile convulsion, symptomatic epilepsies and developmental abnormalities were excluded, and the therapeutic effect and long-term outcome were followed up. Results Forty-two babies were diagnosed to have benign infantile epilepsy by two-year follow-up. Three of them had familial history of benign infantile convulsions. Nineteen percent had mild diarrhea during the onset of convulsions, cluster seizures occurred during a short period in 67% of cases and no status epilepticus occurred. Video-EEG monitoring confirmed seizures originating from temporal, occipital or multifocal areas separately in 3 patients with partial seizures. Interictal EEG background was normal and there were Rolandic small spikes during sleep in 24% of patients. Thirty-nine patients were treated with single antiepileptic drugs and the mean treatment course was 9 months. Three cases did not take medicine. All the patients were seizure free within a year. Conclusion Benign infantile epilepsy should be considered when the following characteristics occur in early atage of the disease: (1) convulsions occurring between 3 to 12 month of age and not later than 24 months of age with or without familial history of benign infantile convulsion; (2) normal psychomotor development before and after convulsion occurs; (3) no evoked factors or only mild diarrhea; (4) majority of cases have partial seizures, or secondary generalized seizures. There are often cluster convulsions during the onset stage, but no status epilepticus; (5) normal EEG background and there may be Rolandic small spikes during sleep; (6) normal neuroimaging.更多还原