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目的总结特发性儿童枕叶癫癎的临床表现及脑电图特点,以提高临床诊断水平。方法回顾性分析2000—2007年广西医科大学第一附属医院收治的21例确诊为特发性儿童枕叶癫癎患儿的临床表现及脑电图特点。结果起病年龄5个月至14岁;发作性呕吐11例,眼球偏转11例,头偏转8例,发作后头痛8例,口咽部自动症5例,眼睑扑动6例,黑蒙5例,视物模糊3例,视幻觉2例;继发半侧肢体抽搐5例,继发全身性发作7例,21例头颅影像学检查均正常。所有病例发作间期脑电图均有癎样放电,闭眼出现,睁眼消失。随访1～5年,其中早发型儿童良性枕叶癫癎(EBOS)12例,晚发型儿童良性枕叶癫癎(LOS)9例,EBOS对多种抗癫癎药物(AEDS)反应较好,12例EBOS患儿中11例单药治疗完全控制发作,1例患儿两种AEDS联合应用可以完全控制发作,IOS对AEDS治疗反应稍差,9例LOS患儿中有2例未完全控制。结论特发性儿童枕叶癫癎是一组较具特征表现的癫癎综合征,掌握临床表现及脑电图特点,常可做出正确诊断。
Objective To summarize the clinical manifestations and EEG features of idiopathic children with occipital lobe epilepsy in order to improve the clinical diagnosis. Methods The clinical features and EEG features of 21 children diagnosed as idiopathic children with occipital lobe epilepsy were analyzed retrospectively from 2000 to 2007 in the First Affiliated Hospital of Guangxi Medical University. Results The age of onset was 5 months to 14 years. There were 11 episodes of vomiting, 11 cases of deflexion, 8 cases of head deflexion, 8 cases of headache after episode, 5 cases of oropharyngeal autopsy, 6 cases of eyelid flutter, Cases, blurred vision in 3 cases, visual hallucinations in 2 cases; secondary hemivertebra limb twitch in 5 cases, secondary to systemic attack in 7 cases, 21 cases of craniography were normal. All cases of interictal EEG showed abnormal discharge, eyes closed, eyes open disappeared. Twelve cases of benign occipital lobe epilepsy (EBOS), 9 cases of benign occipital epilepsy (LOS) in late-onset children were followed up for 1 to 5 years. EBOS responded well to many antiepileptic drugs (AEDS) Eleven patients with EBOS alone had complete control seizures in 12 patients. One patient with both AEDS was able to completely control seizures. The response of IOS to AEDS was slightly worse, and 2 of 9 patients with LOS were incompletely controlled. Conclusion Idiopathic children with occipital lobe epilepsy is a group of more characteristic manifestations of epilepsy syndrome, to grasp the clinical manifestations and characteristics of EEG, often can make the correct diagnosis.