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目的:探讨头痛性癫的诊断及与偏头痛的鉴别诊断。方法:分析由基层医院诊断为头痛性癫的66例患儿的临床资料,经详细询问病史,进行仔细的体格检查,复查脑电图(EEG)1~3次后,重新确定诊断,实施治疗并进行临床随访。结果:在此66例患儿中,28例纠正诊断为偏头痛,32例纠正诊断为神经性头痛。复查EEG结果显示大部分在正常范围,部分异常EEG中以弥漫性慢波增多为主,仅有6例EEG显示有散在样波,结合临床表现符合头痛性癫的诊断。结论:头痛性癫临床少见,单纯以头痛表现诊断为癫是不可靠的,必须依靠临床表现、EEG检查结果综合判断,并和偏头痛进行鉴别。以头痛为主诉的儿童不应轻易诊断为癫。
Objective: To investigate the diagnosis of headache-induced epilepsy and its differential diagnosis with migraine. Methods: The clinical data of 66 cases diagnosed as headache-induced epilepsy in primary hospitals were analyzed. After detailed medical history and detailed physical examination, the EEG was reviewed one to three times before re-diagnosis and treatment And clinical follow-up. Results: Of the 66 patients, 28 were diagnosed as migraine and 32 were diagnosed as having neurological headache. Review EEG results showed that most of the normal range, part of the abnormal EEG diffuse slow wave mainly, only 6 cases of EEG showed scattered in the wave, combined with the clinical manifestations of headache-type epilepsy diagnosis. Conclusion: Headache epilepsy clinical rare, simple diagnosis of epilepsy with headache performance is not reliable, we must rely on clinical manifestations, EEG test results comprehensive judgment, and the identification of migraine. Children with a headache-based complaint should not be easily diagnosed with epilepsy.