Factors influencing clinical features of absence seizures
Factors influencing clinical features of absence seizures
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DOI：
10.1111/j.1528-1167.2008.01708.x
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发表时间：
2008-12-01
期刊：
影响因子：
5.6
通讯作者：
Farrell, Kevin
中科院分区：
文献类型：
--
作者：
Sadleir, Lynette G.;Scheffer, Ingrid E.;Farrell, Kevin
特发性全身性癫痫失神发作的临床特征被认为是特异性的。这一假说是癫痫研究的许多方面的核心，但尚未得到严格的评估。我们研究了癫痫综合征、年龄和状态等特定因素是否决定了失神发作的特征。使用视频脑电图（EEG）记录研究了新出现失神发作的儿童。我们分析了儿童癫痫综合征、年龄、觉醒状态和刺激是否影响失神发作的特殊临床特征：持续时间、眼睑运动、睁眼和发作期间的意识水平。青少年失神性癫痫（JAE），8例;青少年肌阵挛性癫痫（JME），6例;未分类，9例。癫痫发作持续时间与癫痫综合征相关，因为JME儿童的癫痫发作时间短于其他综合征，与年龄无关。年龄独立影响意识水平和眼睛睁开。唤醒或挑衅影响所有功能，但意识水平。儿童特有的特殊因素独立地影响所有特征;这些因素的性质尚未确定。失神发作的临床特征具有综合征特异性模式的观点没有得到批判性分析的支持。我们发现，混杂变量深刻地影响临床特征，综合征也表现出显着的变化。失神发作的临床特征的变化是由许多因素的复杂相互作用引起的，这些因素可能是遗传和环境决定的。
The clinical features of absence seizures in idiopathic generalized epilepsy have been held to be syndrome-specific. This hypothesis is central to many aspects of epilepsy research yet has not been critically assessed. We examined whether specific factors such as epilepsy syndrome, age, and state determine the features of absence seizures.Children with newly presenting absence seizures were studied using video electroencephalography (EEG) recording. We analyzed whether a child's epilepsy syndrome, age, state of arousal, and provocation influenced specific clinical features of their absence seizures: duration, eyelid movements, eye opening, and level of awareness during the seizure.Seizures (509) were evaluated in 70 children with the following syndromes: Childhood absence epilepsy (CAE), 37; CAE plus photoparoxysmal response (PPR), 10; juvenile absence epilepsy (JAE), 8; juvenile myoclonic epilepsy (JME), 6; unclassified, 9. Seizure duration was associated with epilepsy syndrome as children with JME had shorter seizures than in other syndromes, independent of age. Age independently influences level of awareness and eye opening. Arousal or provocation affected all features except level of awareness. Specific factors unique to the child independently influenced all features; the nature of these factors has not been identified.The view that the clinical features of absence seizures have syndrome-specific patterns is not supported by critical analysis. We show that confounding variables profoundly affect clinical features and that syndromes also show marked variation. Variation in clinical features of absence seizures results from a complex interaction of many factors that are likely to be genetically and environmentally determined.