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脑性瘫痪伴临床下癫样放电临床特征分析
Clinical analysis of subclinical epileptiform discharges in children with cerebral palsy
【摘要】 目的探讨脑性瘫痪患儿伴发临床下癫样放电的临床特征及相关危险因素。方法对2004年1月-2007年12月期间在青岛市残疾儿童医疗康复中心治疗的279例脑瘫患儿进行详细的病史采集、脑电图及影像学检查、认知功能评定,分析不同类型脑瘫患儿临床下癫样放电的伴发率及脑电图表现,采用Logistic逐步回归分析显示认知水平、影像学改变、新生儿期惊厥史、出生胎龄及合并症等因素,对脑瘫伴发临床下癫样放电的影响。结果18.64%(52/279)的脑瘫患儿伴发了临床下癫样放电,痉挛型偏瘫患儿的发生率最高(36.36%),四肢瘫患儿最低(6.25%)。所有脑瘫类型均以局灶性或多灶性放电占多数。不同DQ/IQ水平局灶性与全面性放电的比例差异无统计学意义。皮层损伤及存在合并症是脑瘫伴发临床下疒间样放电的危险因素,而认知水平、新生儿期惊厥史及出生胎龄与之无明显关系。结论脑性瘫痪常伴发临床下癫样放电,尤其见于痉挛型偏瘫,以局灶性或多灶性放电多见。皮层受损及存在合并症对脑瘫伴发临床下疒间样放电有预测价值。
【Abstract】 Objectives To investigate the clinical features and the related risk factors of subclinical epileptiform discharges in children with cerebral palsy.Methods Total number of 279 children with cerebral palsy treated in Qingdao Rehabilitation Center For Disabled Children from January 2004 to December 2007 were recruited.Their medical histories,electronic encephalograms(EEG),imaging findings and cognitive levels were used to evaluate the incidence and the EEG manifestations of subclinical epileptiform discharges in different types of cerebral palsy.Relationship between subclinical epileptiform discharges and cognitive level,imaging abnormality,neonatal seizure history,gestational age and complications were analyzed with logistic stepwise regression.Results The overall incidence of subclinical epileptiform discharges in cerebral palsy was 18.64%(52/279),with the highest in spastic hemiplegia(36.36%) and the lowest in tetraplegia(6.25%).The focal and multifocal epileptiform discharges were the majority in all types of cerebral palsy.There was no statistical significance between focal and general epileptiform discharges in different development quotion or intelligence quotion levels.The cortex impairment and other complications were risk factors related to subclinical epileptiform discharges in cerebral palsy,while cognitive level,neonatal seizure history and gestational age were not.Conclusions Subclinical epileptiform discharges,with the major pattern of focal and multifocal,is common in children of cerebral palsy,especially in hemiplegia type.The existence of brain cortex impairment and other complications may have predictive value of subclinical epileptiform discharges in cerebral palsy.
【Key words】 cerebral palsy; subclinical epileptiform discharges; related risk factors; predictive value;
- 【文献出处】 临床儿科杂志 ,Journal of Clinical Pediatrics , 编辑部邮箱 ,2009年02期
- 【分类号】R742.3;R742.1
- 【被引频次】9
- 【下载频次】80