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目的分析小儿枕叶癫的临床特点及脑电图资料,以提高诊断水平。方法对1997-09—2006-06成都市儿童医院收治的35例枕叶癫患儿的临床表现和脑电图进行分析。结果1097例癫疒间患儿中,枕叶癫35例(3.2%),男23例,女12例,确诊时病程1d至6年,平均1年5个月。其中早发型儿童良性枕叶癫(EB-OS)13例,晚发型儿童枕叶癫(LOS)16例,症状性枕叶癫6例。EBOS组发病年龄(4.08±2.19)岁,以运动性发作多见,占84.6%(11/13);LOS组发病年龄(7.28±3.92)岁,视觉症状占56.3%(9/16)、偏头痛症状56.3%(9/16);症状性枕叶癫疒间组发病年龄(1.51±0.76)岁,均为运动性发作。脑电图特征为发作间期一侧或双侧枕叶的高幅棘波、棘慢波或尖波发放,闭眼出现,睁眼消失。结论小儿枕叶癫疒间临床表现复杂多样,容易误诊,应熟悉临床特点,重视视觉症状,结合发作间期脑电图枕叶放电特征,可作出正确诊断。
Objective To analyze the clinical characteristics of pediatric occipital lobe epilepsy and EEG data to improve the diagnostic level. Methods The clinical manifestations and electroencephalogram of 35 cases with occipital lobe epilepsy admitted to Chengdu Children’s Hospital from 1997-09 to 2006-06 were analyzed. Results Among 1097 cases of epilepsy, 35 cases (3.2%) had occipital lobe epilepsy. There were 23 males and 12 females. The course of disease was from 1d to 6 years with an average of 1 year and 5 months. Among them, 13 cases were early-onset children with benign occipital lobe epilepsy (EB-OS), 16 cases with late onset occipital lobe epilepsy (LOS) and 6 cases with symptomatic occipital lobe epilepsy. The age of onset in the EBOS group (4.08 ± 2.19) years was higher than that in the exercise group, accounting for 84.6% (11/13). The age of onset in the LOS group (7.28 ± 3.92 years) was 56.3% (9/16) Headache symptoms 56.3% (9/16); symptom occipital epilepsy group age (1.51 ± 0.76) years of age, are motile attacks. EEG is characterized by one or both sides of the epiphysis occipital spikes high spikes, Spike slow wave or spike release, eyes closed, eyes disappear. Conclusions The clinical manifestations of infantile occipital lobe epilepsy are complex and diverse, and are easy to be misdiagnosed. Clinical features should be familiar with, and visual symptoms should be emphasized. Combined with the characteristics of occipital lobe discharge in interictal period, correct diagnosis can be made.