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头痛型癫痫主要表现为发作性剧烈头痛,可伴有短暂的意识障碍、植物神经症状。多见于儿童与青少年,脑电图是诊断头痛型癫痫的一种重要的辅助诊断手段。现将10例头痛型癫痫的诊断治疗报告如下。 1 临床资料 本组10例中,男6例,女4例,年龄为5～15岁。其中15岁以下者为5例,10～15岁者5例,有抽搐史3例,有癫痫史2例。10例中发作先兆为头昏伴恶心3例,头面部发热3例,感眼前“闪光”3例,前额部头痛1例。头痛性质为绞痛4例;胀痛4例;灼痛2例。发作时间10分钟至半小时,大多数患者每月均有2～3次或数次不等发作。病程最长者为5年,最短者1月。全部病例经神经科常规检查未发现任何阳性体征。脑电图显示以下三种情况:①3例两侧高波幅同步的3～4Hz活动的尖—慢综合波。②2例各区以拟波为主并隙发或爆发尖波。③5例阵发性或爆发性之波幅同步或不同步δ波。符合头痛型癫痫的诊断。治疗:10例病人在未确诊为头痛型癫痫之后改用抗癫痫药物
Headache type epilepsy mainly for the onset of severe headache, may be associated with transient disturbance of consciousness, autonomic symptoms. More common in children and adolescents, EEG diagnosis of headache-type epilepsy is an important diagnostic tool. Now 10 cases of headache-type epilepsy diagnosis and treatment report is as follows. 1 Clinical data The group of 10 patients, 6 males and 4 females, aged 5 to 15 years. Including 15 years of age in 5 cases, 10 to 15 years in 5 cases, 3 cases of convulsions, history of epilepsy in 2 cases. 10 cases of attack precursors dizziness with nausea in 3 cases, 3 cases of head and face fever, sensory eye “flash” in 3 cases, 1 case of forehead pain. Headache in 4 cases of colic; pain in 4 cases; burning in 2 cases. Attack time of 10 minutes to half an hour, most patients every month 2 to 3 times or several times ranging from attack. The longest course of 5 years, the shortest in January. All cases were routinely neurological examination found no positive signs. EEG shows the following three cases: ① 3 cases of high amplitude synchronized on both sides of 3 ~ 4Hz activity of sharp - slow wave. ② 2 cases in each area to the main wave and break out or spike wave. ③ 5 cases of paroxysmal or explosive wave amplitude synchronous or asynchronous δ wave. In line with headache-type epilepsy diagnosis. Treatment: 10 patients switched to antiepileptic drugs without diagnosis of headache-type epilepsy