CAJ | 학술논문

目的了解轻度胃肠炎伴婴幼儿惊厥患儿惊厥发作期及发作间期的脑电图改变,并通过追踪随访了解此类患儿的脑电图演变及惊厥复发情况.方法对2005年1月至2009年12月我院神经内科住院治疗的轻度胃肠炎伴婴幼儿惊厥患儿的临床资料进行回顾性分析,进行电话或门诊随访3～7年,了解患儿惊厥发作情况.结果 (1) 128例患儿中,胃肠炎急性期惊厥发作间期脑电图128份,发作期脑电图4份(共5次).其中63例发作间期脑电图未见癫(痫)样波发放,65例于不同导联见少许癫(痫)样波发放,48/65例位于中央及中央中线位置.在5次发作期脑电图中,2次发生于同一患儿的同一次监测过程中,异常波均起源于局部且起源部位不固定.2个月后脑电图复查57例,52例癫(痫)样波消失,其他5例仍可见少量的癫(痫)样波发放.(2) 128例患儿在随访中失访25例,96例无发作,3例以发热为诱因出现惊厥发作,2例又在胃肠炎期间再次出现惊厥发作,未予抗癫治(痫)疗,1.5～3.0年未再发作,2例出现数次不明原因的无热惊厥,诊断为癫(痫)并给予了抗癫(痫)治疗,现1.5 ～2.5年时间暂无发作.结论 (1)轻度胃肠炎伴婴幼儿惊厥患儿在胃肠炎急性期惊厥发作间期脑电图近半数可见癫(痫)样放电,且放电部位多在中央区及其中线；(2)发作期脑电图均局部起源；(3)轻度胃肠炎伴婴幼儿惊厥患儿有惊厥再发的危险,尤其是存在诱发因素情况下,个别患儿可转化为癫(痫).
목적 료해경도위장염반영유인량궐환인량궐발작기급발작간기적뇌전도개변,병통과추종수방료해차류환인적뇌전도연변급량궐복발정황.방법 대2005년1월지2009년12월아원신경내과주원치료적경도위장염반영유인량궐환인적림상자료진행회고성분석,진행전화혹문진수방3～7년,료해환인량궐발작정황.결과 (1) 128례환인중,위장염급성기량궐발작간기뇌전도128빈,발작기뇌전도4빈(공5차).기중63례발작간기뇌전도미견전(간)양파발방,65례우불동도련견소허전(간)양파발방,48/65례위우중앙급중앙중선위치.재5차발작기뇌전도중,2차발생우동일환인적동일차감측과정중,이상파균기원우국부차기원부위불고정.2개월후뇌전도복사57례,52례전(간)양파소실,기타5례잉가견소량적전(간)양파발방.(2) 128례환인재수방중실방25례,96례무발작,3례이발열위유인출현량궐발작,2례우재위장염기간재차출현량궐발작,미여항전치(간)료,1.5～3.0년미재발작,2례출현수차불명원인적무열량궐,진단위전(간)병급여료항전(간)치료,현1.5 ～2.5년시간잠무발작.결론 (1)경도위장염반영유인량궐환인재위장염급성기량궐발작간기뇌전도근반수가견전(간)양방전,차방전부위다재중앙구급기중선；(2)발작기뇌전도균국부기원；(3)경도위장염반영유인량궐환인유량궐재발적위험,우기시존재유발인소정황하,개별환인가전화위전(간).
Objective In present study,we aimed to investigate the ictal and interictal electroencephalography (EEG) changes in patients with infantile convulsions with mild gastroenteritis,to understand the evolution of EEG and recurrence of convulsion by follow-up.Methods In this retrospective study,all patients with infantile convulsions with mild gastroenteritis visited our hospital from January 2005 to December 2009 were included,and were followed up for 3 to 7 years.All their clinical data were summarized and analyzed.Results Fist of all,we collected 128 interictal EEGs and 4 ictal (5 episodes) reports.Based on interictal EEGs,no discharge was observed in 63 subjects,and epileptic waves were discovered in other 65 patients.In most cases (48/65) epileptic waves were found to be located in the central area.For all 5 recorded ictal EEGs (2 were from same patient),epileptic waves were originated from different regions.Two months later,epileptic waves disappeared in 52/57 cases,but there were still discharge in 5 cases.Secondly,in the 103 cases who were successfully followed up,96 were seizure free,5 had recurrence during fever (3 cases) or gastroenteritis (2 cases),but remained seizure free for last 1.5 to 3.0 years.Overall,convulsion was recurred in 2 cases and finally diagnosed as epilepsy and then treated with antiepileptic drug,keeping seizure free for recent 1.5 to 2.5 years.Conclusion (1) Discharge can be found in nearly half of interictal EEGs in cases with infantile convulsion with mild gastrocnteritis,and most of them are located in central region.(2) All discharge come from local origin in ictal EEGs.(3) Seizure may recur in cases with infantile convulsion with mild gastroenteritis,especially in the presence of causative factors.Some children have risk of developing epilepsy.