Evolution of Childhood Absence Epilepsy, Juvenile Myoclonic Epilepsy and Epilepsy with Grand Mal on Awakening

兒童失神癲癇，青少年肌抽躍癲癇及清醒泛發性癲癇：臨床演變相關性之研究

夏文傑(Wen-Jye Shian) ； 遲景上(Ching-Shiang Chi)

《Acta Paediatrica Sinica》 35卷2期 (1994/04) Pp. 119-123

https://doi.org/10.7097/APS.199404.0119

摘要

此篇文章針對門診1931位兒童癲癇中，選出71位診斷爲兒童失神癲癇(50/71)，青少年肌抽躍癲癇(7/71)，以及清醒泛發性癲癇(14/71)之中國兒童，作一臨床與腦波紀錄之回顧性研究。過度換氣是兒童失神癲癇病人，最常見的誘發因素；睡眠不足則是青少年肌抽躍癲癇，以及清醒泛發性癲癇病人，最主要的誘發因素。就腦波紀錄而言，廣泛性快頻率蕀波或多蕀波複合波型(≧3HZ)，是最常見的發現。三位青少年肌抽躍癲癇病童(42%)，以及四位清醒泛發性癲癇病童(28%)，在診斷之前的五至七年，曾被診斷爲兒童失神癲癇。十六位兒童失神癲癇病人(32%)，後來演變成清醒泛發性癲癇。所有青少年肌抽躍癲癇病童，在診斷時均合併有清醒泛發性癲癇；而三位清楚泛發性癲癇病童(21%)，在診斷時合併有青少年肌抽躍癲癇。就這些病人而言，兒童失神癲癇，青少年肌抽躍癲癇，以及清醒泛發性癲癇之間，存在著強烈的演變相關性。

並列摘要

Seventy-one Chinese children with idiopathic generalized epilepsy, from among 1931 pediatric epileptics, were reviewed clinically and electroencephalo graphically. They were classified under childhood absence epilepsy (CAE, 50/71), juvenile myoclonic epilepsy (JME, 7/71) and epilepsy with grand mal on awakening (GMA, 14/71). All the patients’ family members with epilepsy were classified under idiopathic generalized epilepsy. Hyperventilation was the most common precipitating factor for CAE, and sleep deprivation was the most common one for .JME and GMA. Electroencephalographically, fast generalized spike or polyspike-wave complex (≥3Hz) was the most common feature. Three JME (42%) and 4 GMA patients (28%) had been diagnosed as CAE about 5 to 7 years preceding JME and GMA, respectively. Sixteen CAE cases (32%) later evolved to be GMA. All JME patients had concomitant GMA and three GMA cases (21%) had concomitant JME at diagnosis. There is strong evolutional correlation among CAE, JME and GMA in this series.

並列關鍵字

absence epilepsy ； juvenile myoclonic epilepsy ； grand mal on awakening