84例脑性瘫痪患儿合并癫痫的临床特征

摘要

目的:研究脑性瘫痪患儿合并癫痫的临床特征.方法:收集我科84例脑瘫合并癫痫患几的临床资料为观察组,收集同期57例脑瘫不伴癫痫患儿为对照组,探讨脑瘫患儿合并癫痫临床特征.结果:84例脑瘫合并癫痫患儿中,痉挛型四肢瘫40例(47.6％),其次为痉挛型偏瘫21例(25.0％);癫痫首次发作年龄＜1岁45例(53.6％),其中痉挛型四肢瘫18例(45％);脑瘫合并癫痫发作类型中,强直-阵挛性发作39例(46.4％),局灶性发作18例(21.4％),婴儿痉挛症13例(15.5％);脑瘫患儿合并癫痫的头颅影像学表现以灰质合并(或)白质损伤为主;脑电图异常以局灶性痫性放电为主.两组的脑瘫类型、头颅影像学及脑电图比较,差异有统计学意义(P＜0.05).结论:痉挛型四肢瘫患儿更易发生癫痫,且多数＜1岁时发病,强直-阵挛型发作占首位.头颅影像学及脑电图检查对早期癫痫诊断及判断预后具有重要意义.%Objective:To study the clinical features of epilepsy(EP)in children with cerebral palsy(CP).Methods:The clinical data of 84 CP children with EP were collected and compared with that of 57 CP children without EP,to explore clinical characteristics of EP in children with CP.Results:In 84 CP children with EP,40 cases (47.6％)were spastic tetraplegia,and 21 cases (25.0％)were spastic hemiplegia.There were 45 cases (53.6％) have the onset of EP before one years old,and 18 cases (45％)were spastic tetraplegia.Among 84 CP children complicated with EP,39 cases (46.4％)were tonic-clonic seizures,18 cases (21.4％) were of focal seizures,13 cases(15.5％)were infantile spasms.Brain imaging changes mainly focused on gray matter or gray and white matter damage,and localized epileptic discharge was commonly seen in EEG changes.Compared with children with CP without EP,the types of CP,brain imaging and EEG of children with CP combined with EP have statistical significance.Conclusion:EP is more likely to occur in children with spastic tetraplegia.Most onset time of EP is before one years old,and tonic-clonic seizures is dominate in CP children.The brain imaging and EEG have great significance to early diagnosis of EP and the judgement of the prognosis.