脑瘫儿童癫痫的临床特征和可能的危险因素:三级中心经验

D. Ardıçlı, Ö. Dedeoglu
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引用次数: 0

摘要

目的:评价脑瘫(CP)患儿的临床特点,探讨脑瘫(CP)患儿癫痫的可能危险因素及预后,重点探讨耐药癫痫(DRE)。材料与方法:对2019年至2022年间诊断为CP的145例儿科患者进行随访。人口统计学特征、产前/围产期病史、病因和CP类型、运动和认知功能损害程度、癫痫类型、神经影像学和脑电图(EEG)结果回顾性地从医院记录中获得。将患者分为两组:CP合并癫痫患者和非癫痫患者。比较两组之间以及DRE组与控制癫痫组之间的研究变量。结果:男91例(63%),女54例(37%),平均年龄11.1±4.2岁(3 ~ 18岁)。107例(73.7%)存在癫痫,其中40.1%为难治性癫痫。癫痫在四肢瘫痪型CP中最为常见(p=0.028)。癫痫患者足月妊娠、出生体重≥2500 g、新生儿癫痫发作史显著增高(p分别=0.03、0.01、0.03)。患有DRE的儿童更有可能患有四肢瘫痪性CP(50%)和严重智力残疾(56%)。结论:确定潜在危险因素对预测CP患者癫痫的发展具有重要意义,可为高危患者提供更密切的随访。应特别注意早期识别和治疗共病癫痫患儿CP。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical Characteristics and Possible Risk Factors of Epilepsy in Children with Cerebral Palsy: A Tertiary-Center Experience
Objective: The aim of this study was to evaluate the clinical characteristics of children with cerebral palsy (CP) and to investigate possible risk factors and prognosis of epilepsy in children with cerebral palsy (CP) with a special emphasis on drug-resistant epilepsy (DRE). Materials and Methods: A total of 145 pediatric patients who were followed up with a diagnosis of CP between 2019 and 2022 were evaluated. Demographic features, prenatal/perinatal history, etiology and type of CP, degree of impairment in motor and cognitive functions, seizure type, neuroimaging, and electroencephalography (EEG) findings were obtained retrospectively from hospital records. The patients were divided into two groups: CP patients with epilepsy and patients without epilepsy. Study variables were compared between these two groups and also between DRE and controlled epilepsy groups. Results: There were 91 (63%) boys and 54 (37%) girls with a mean age of 11.1 ± 4.2 years (3-18 years). Epilepsy was present in 107 (73.7%) cases and 40.1% of them had refractory epilepsy. Epilepsy was most common in the tetraplegic form of CP (p=0.028). Term gestation, birth weight of ≥2500 g, and history of neonatal seizures were significantly higher in patients with epilepsy (p=0.03, 0.01, and 0.03, respectively). Children with DRE were more likely to have tetraplegic CP (50%) and severe intellectual disability (56%). Conclusion: Determination of potential risk factors is important in predicting the development of epilepsy in patients with CP, as it may provide closer follow-up of patients at high risk. Particular attention should be paid to the early identification and treatment of comorbid epilepsy in children with CP.
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