CAJ | 학술논문

目的：回顾性分析儿童额叶惊恐发作癫?的临床特征及对奥卡西平（OXC ）或卡马西平（CBZ ）单药治疗的反应，总结其临床特点及疗效。方法：收集2009～2013年我院门诊及住院病人，以惊恐发作为主要临床症状，结合发作间期及发作期的视频脑电图（V‐EEG ），诊断为额叶惊恐发作癫?的患儿43例，其中资料完整者39例，随访时间为2．6～4年，分析其临床特点及对OXC或CBZ的治疗的反应及长期疗效。结果：39例患儿，年龄2岁零8个月～11岁零7个月，惊恐发作为主要症状，平均每天发作13．8次。头颅M R 36例正常，2例脑白质髓鞘发育稍落后，1例脑沟加深。V‐EEG 37例提示发作期额区放电。33例首选单药OXC或CBZ ，9例服药第1天起无发作，OXC用量平均为15．8 mg／kg ，CBZ为11．5 mg／kg。长期无发作25例（76％）（在服药第1天或2周起无临床发作）。结论：以惊恐发作为主要症状的儿童额叶癫?，首选OXC或CBZ单药治疗疗效显著，起效快，且低剂量可维持高的长期无发作状态。
목적：회고성분석인동액협량공발작전?적림상특정급대오잡서평（OXC ）혹잡마서평（CBZ ）단약치료적반응，총결기림상특점급료효。방법：수집2009～2013년아원문진급주원병인，이량공발작위주요림상증상，결합발작간기급발작기적시빈뇌전도（V‐EEG ），진단위액협량공발작전?적환인43례，기중자료완정자39례，수방시간위2．6～4년，분석기림상특점급대OXC혹CBZ적치료적반응급장기료효。결과：39례환인，년령2세령8개월～11세령7개월，량공발작위주요증상，평균매천발작13．8차。두로M R 36례정상，2례뇌백질수초발육초락후，1례뇌구가심。V‐EEG 37례제시발작기액구방전。33례수선단약OXC혹CBZ ，9례복약제1천기무발작，OXC용량평균위15．8 mg／kg ，CBZ위11．5 mg／kg。장기무발작25례（76％）（재복약제1천혹2주기무림상발작）。결론：이량공발작위주요증상적인동액협전?，수선OXC혹CBZ단약치료료효현저，기효쾌，차저제량가유지고적장기무발작상태。
Objective:To make retrospective analysis of clinical characters of ictal fear in children with frontal lobe epilepsy ,and summarize the drug responsiveness and treatment effect of oxcarbazepine (OXC)or carbamazepine(CBZ) monotherapy for ictal fear in frontal lobe epilepsy .Methods :Pediatric pa‐tients with ictal fear as the main feature in our clinic and inpatient department between January 2009 and December 2013 were involved in the stydy .43 children were diagnosed as ictal fear in frontal lobe epilepsy based on interictal and ictal video electroencephalogram (VEEG) .Among them 39 had sufficient infor‐moation .Follow‐up period was 2 .6~4years .The clinical characters of ictal fear in frontal lobe epilepsy and long‐term efficacy of OXC /CBZ monotherapy were analyzed retrospctively .Results:39 patients aged 2 .8~11 .7years with ictal fear as the main symptom were involved .The frequency of average ictal fear onset occured 13 .8 per day .The cranial MRI of 36 cases was normal ,delayed white matter myelination was found in 2 case ,deeped sulcus was in one case ,V‐EEG of 37 cases showed ictal frontal onset .Out of 33 patients who took OXC or CBZ at first .9 cases had no seizure since the first day and 25 cases(76% ) suffered from long‐term seizure .The average dose of OXC was 15 .8 mg/kg · d or that of CBZ was 11 .5 mg/kg · d .Conclusion:OXC or CBZ monotherapy in children with ictal fear in frontal lobe epilepsy is the first choice of therapy .Its treatment effect is distinct and obvious .Low dose can maintain long‐term seizure free .