ICTAL CLINICAL ELECTROENCEPHALOGRAPHIC FINDINGS OF SPASMS IN WEST SYNDROME
ICTAL CLINICAL ELECTROENCEPHALOGRAPHIC FINDINGS OF SPASMS IN WEST SYNDROME
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DOI：
10.1111/j.1528-1157.1993.tb00445.x
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发表时间：
1993-07-01
期刊：
影响因子：
5.6
通讯作者：
VIGEVANO, F
中科院分区：
文献类型：
--
作者：
FUSCO, L;VIGEVANO, F
本文回顾了955例不明原因和症状性West综合征（WS）患儿的脑电图/录像记录，以确定痉挛的临床表现与脑电图模式之间的关系，并检查这些特征是否反映了WS的病因和预后。回顾证实痉挛是一种独特的癫痫发作类型，具有独特的临床和脑电图模式，不同于所有其他公认的癫痫发作。对称性痉挛存在于隐源性和有症状的患者中。相反，不对称痉挛或痉挛期间可识别的局灶性体征强烈表明存在脑损伤。在两个病因组中，痉挛的特征性发作EEG模式由正顶点慢波组成。另外两种模式显然与痉挛相关，一种是快速活动，这里称为纺锤形活动，另一种是递减活动。快速活动对应于临床凝视，而递减活动，当存在时，代表发作后事件。尽管与痉挛的病因无关，但在一组痉挛期间持续性心律失常似乎是与有利结局相关的EEG模式。
The electroencephalographic/video recordings of 955 spasms in children with cryptogenic and symptomatic West syndrome (WS) were reviewed to define the relation between a clinical manifestation of a spasm and its EEG pattern, and to examine whether these features reflect the etiology and prognosis of WS. The review confirmed the spasm to be a distinct type of seizure, with a unique clinical and EEG pattern unlike that of all other recognized seizures. Symmetric spasms were present in cryptogenic and symptomatic patients. In contrast, asymmetric spasms, or focal signs recognizable during a spasm, strongly indicated the existence of a cerebral lesion. In both etiological groups, the characteristic ictal EEG pattern of the spasms consisted of a positive-vertex slow wave. The other two patterns apparently correlated to a spasm, were fast activity, here called spindle-like, and decremental activity. The fast activity corresponded to a clinical stare, and the decremental activity, when present, represented a postictal event. Although it was independent from the etiology of the spasms, persisting hypsarrhythmia during a cluster of spasms appeared to be an EEG pattern that correlated with a favorable outcome.