- 期刊
Childhood Occipital Epileptic Syndromes in Taiwan: Clinical Characteristics and Outcomes
台灣兒童枕葉癲癇症候群：臨床特徵與預後分析
摘要
背景：枕葉癲癇為源自於大腦枕葉放電引發的抽搐。三種枕葉癲癇症候群，早發性、晚發性、及症狀性枕葉癲癇症候群各有不同的特徵。瞭解這三種不同的症候對癲癇兒童照護者極為重要。 方法：回顧病例，以本院54個兒童罹患枕葉性癲癇症候群（18早發性、10晚發性、26症狀性）；比較三組的臨床特徵、抽搐形式、腦波、治療、及預後。 結果：夜間抽搐常發生於早發性枕葉癲癇(55%)；而晚發性及症狀性癲癇較常有日間抽搐；分別為80%及61% (P=0.04)。33%早發性枕葉癲癇有重積抽搐；而晚發性較少見到。自主神經的前兆及繼發性全身抽搐較常在症狀性癲癇發生(P=0.03)。在5年追蹤後，早發性有72%、晚發性有60%、症狀性有19.2%；腦波轉變為正常。預後部份以早發性最佳，其次為晚發性。症狀性癲癇預後最差。 結論：這研究顯示三種癲癇症候群的不一樣特徵及預後。這個研究提供臨床人員診斷、治療、及預後參考的依據。
並列摘要
Background: The present study aimed to elucidate the clinical characteristics and outcomes of three types of occipital epileptic syndromes: early-onset and late-onset childhood epilepsy with occipital paroxysm (ECEOP and LCEOP) and symptomatic occipital epilepsy (SOLE). Methods: We retrospectively reviewed the medical records of 54 children (18 ECEOP, 10 LCEOP, and 26 SOLE) and compared the clinical features, EEG findings, treatments, and outcomes among these patients. Results: Nocturnal seizures occurred in 55% of the patients with ECEOP, whereas of those with LCEOP and SOLE, 80% and 61% had diurnal seizures, respectively (P=0.04). Status epilepticus was more common in the ECEOP group, less in LCEOP. Autonomic auras were more common in the SOLE group than in the other two groups. Secondary generalized seizure was often found in the SOLE group (P=0.03). EEG findings in 72% of the ECEOP group, 60% of the LCEOP group, and 19.2% in the SOLE group were changeable and became to be normal after 5 years of follow-up. Slow EEG background activity was more evident in the SOLE group than in the other two groups. The prognoses of these groups of patients were different. The ECEOP group had the best, and the SOLE group had the worst. Conclusions: These findings suggest that some clinical features of these three syndromes differ from each other, which may provide clinicians a basis for determining the appropriate diagnosis in children with one of these childhood occipital epileptic syndromes.