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目的了解伴有非癫癎发作的脑性瘫痪(脑瘫)的临床特点,以提高与癫癎发作的鉴别能力。方法 1198例9个月至6岁的脑瘫患儿纳入研究,对伴随发作性症状的患儿进行24h视频脑电图监测,明确伴随的发作是否为癫癎发作,并观察伴随非癫癎发作患儿的发作症状、年龄、脑瘫型别及脑电图特征。结果共578例(48.24%)患儿伴随发作性症状,其中伴随癫癎发作者231例(19.28%),非癫癎发作322例(26.88%)。322例伴随非癫癎发作的脑瘫患儿中,发作性症状包括非癫癎性强直发作、发作性摇头、耸肩或头后仰、发作性哭闹、惊恐发作、睡眠肌阵挛、刻板性运动等;158例(49.1%)显示脑电图有非特异性异常;111例(34.5%)在基层医院误诊为癫癎;1岁以内患儿非癫癎发作频率高于1岁～和3～6岁组患儿;痉挛型脑瘫患儿非癫癎发作频率最高(168例,52.2%),其次为不随意运动型(69例,21.4%)和混合型(65例,20.2%)。结论脑瘫患儿伴随的发作性症状部分为非癫癎发作,注意与癫癎发作相鉴别。非癫癎发作发生频率与患儿年龄及脑瘫型别有一定关系。
Objective To understand the clinical features of cerebral palsy (cerebral palsy) associated with non-epileptic seizures in order to improve the ability of distinguishing epileptic seizures. METHODS: A total of 1198 children with cerebral palsy, aged 9 months to 6 years, were enrolled in the study. Patients with accompanying symptoms were monitored by 24-h video EEG to ascertain if the seizure was associated with epileptic seizures and to observe the presence of seizures Children’s seizures, age, cerebral palsy type and EEG features. Results A total of 578 patients (48.24%) were accompanied by the onset of symptoms, including 231 cases (19.28%) with epilepsy and 322 cases (26.88%) with non-epileptic seizures. In 322 children with cerebral palsy who had non-epileptic seizures, the seizure symptoms included non-epileptic tonic seizures, seizures, shrugs or head-back, episodic crying, panic attacks, sleep-muscle clonus, stereotypic motor activity (49.1%) showed nonspecific EEG abnormalities; 111 cases (34.5%) were misdiagnosed as epilepsy in grass-roots hospitals; the frequency of non-epileptic seizures in children younger than 1 year was higher than 1 year old and 3-6 The children with spastic cerebral palsy had the highest frequency of non-epileptic seizures (168 cases, 52.2%), followed by involuntary exercise (69 cases, 21.4%) and mixed type (65 cases, 20.2%). Conclusion Some children with cerebral palsy have episodes of non-epileptic seizures, which should be distinguished from epileptic seizures. The frequency of non-epileptic seizures and children age and cerebral palsy type has a certain relationship.