【摘要】 目的:分析儿童植物神经发作性癫痫的临床特点,探讨其病因、诊断及预后的相关因素。方法:对1996～2005年本院收治的62例植物神经发作性癫痫患儿进行回顾性分析,包括病因、临床表现、发作类型、脑电图及神经影像学检查等。结果:男童23例(37.1%),女童39例(62.9%);7岁以上38例(61.3%);病程在6个月内29例(46.8%),1年内46例(74.2%)。病因较明确54例(87.1%),其中最常见为围生期窒息16例(25.8%),其余依次为高热惊厥10例(16.1%)、脑发育畸形9例(14.5%)、产伤6例(9.7%)、颅脑外伤5例(8.1%)、中枢神经系统感染4例(6.5%)、癫痫发作家族史3例(4.8%)、脑动脉瘤1例。腹型癫痫25例(40.3%),头痛型癫痫20例(32.3%),再发性呕吐17例(27.4%)。常规脑电图检查59例有痫样放电,阳性率95.2%;55例患儿进行了神经影像学检查,其中21例(38.2%)有异常发现。治疗有效48例,总有效率77.4%。影响疗效的主要因素有脑电图异常程度、发病年龄及病程。结论:脑电图对诊断至关重要,要注意提高其阳性率;神经影像学检查有助明确病因;脑电图异常程度轻、发病年龄小、早期治疗有助改善预后。更多还原

【Abstract】 Objective:To investigate clinical characteristics in children with autonomic epilepsy, and try to approach the factors related to causa morbi, diagnosis and prognosis of this disease.Methods:62 epileptic children who admitted to our hospital from 1996 to 2005 were studied by retrospective analysis including causa morbi, clinical manifestation, seizure type, examination of electroencephalogram(EEG) and nerve imaging.Results:Of 62 cases, there were 39(62.9%) girls and 23(37.1%) boys; there were 38 children (61.3%) over 7 years of age; 29(46.8%) cases with the course of 6 months, compared with 46(74.2%) cases of 1 year. 54(87.1%) cases with definite causa morbi, of which the most commonly encountered were 16(25.8%) of perinatal asphyxia, followed by 10(16.1%) with febrile seizures, 9(14.5%) with encephalodysplasia, 6(9.7%) with birth injury, 5(8.1%) with craniocerebral trauma, 4(6.5%) with central nervous system infection, 3(4.8%) with epileptic family history, 25(40.3%) cases with abdominal epilepsy, 20(32.3%) cases with headache epilepsy, and 17(27.4%) cases with recurrent vomiting.Routine EEG examination demonstrated that there were 59 cases with epileptiform discharge, of which the positive incidence was 95.2%; Nerve imaging examination were performed in 55 cases, of which there were unusual finds in 21(38.2%)cases. Effective treatment was reflected in 48 cases and the general effective incidence was 77.4%. The main factors of curative effect were the abnormal degree of EEG, age of onset and epileptic course.Conclusion:In epileptic diagnosis, EEG is the most important examination and should be paid to improving the positive incidence. Nerve imaging examination helps to define the causa morbi. Slighter EEG abnormality, younger in age of onset, and early treatment contribute to better prognosis.更多还原