Outcome of children with hyperventilation-induced high-amplitude rhythmic slow activity with altered awareness
Outcome of children with hyperventilation-induced high-amplitude rhythmic slow activity with altered awareness
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DOI：
10.1111/j.1469-8749.2012.04337.x
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发表时间：
2012-11-01
影响因子：
3.8
通讯作者：
Mordekar, Santosh R.
中科院分区：
文献类型：
--
作者：
Barker, Alexander;Ng, Joanne;Mordekar, Santosh R.
过度换气引起的高振幅节律性慢活动伴意识改变（HIHARS）越来越多地在儿童中被发现，并被认为是一种与年龄相关的非癫痫性电图现象。我们回顾性调查了 15 名 HIHARS 儿童（6 名男性，9 名女性）的临床结果（平均年龄 7 岁，标准差 1 岁 11 个月；范围 4 岁 6 个月 11 岁）。 11 例患者的主要症状是大脑一片空白，其中 2 名儿童还患有全身性强直阵挛性癫痫发作 (GTCS)，其中 1 名儿童的主要问题是学业成绩恶化。三名儿童出现局灶性运动性癫痫发作的症状。在仅出现空白期的 9 名儿童中，进一步随访（平均持续时间 18 个月，标准差 21 个月）显示，其中 6 名儿童的症状完全缓解，但 3 名儿童的症状持续存在。在我们的研究中，患有 HIHARS 的儿童出现单独的空白期症状似乎会自发消退，并且不会演变成惊厥性癫痫发作或其他被认为明显是癫痫的阵发性事件。临床特征提示 GTCS 或局灶性运动性癫痫发作（伴或不伴空白期）和/或发作间期脑电图显示癫痫样放电的儿童（患有 HIHARS）随后被诊断为癫痫。
Hyperventilation-induced high-amplitude rhythmic slow activity with altered awareness (HIHARS) is increasingly being identified in children and is thought to be an age-related non-epileptic electrographic phenomenon. We retrospectively investigated the clinical outcome in 15 children (six males, nine females) with HIHARS (mean age 7y, SD 1y 11mo; range 4y 6mo11y). The presenting feature in 11 cases was blank spells two of these children also had generalized tonicclonic seizures (GTCS) and in one individual the main concern was deteriorating school performance. Three children had symptoms suggestive of focal motor seizures. Of the nine children presenting solely with blank spells, further follow-up (mean duration 18mo, SD 21mo) revealed full resolution of symptoms in six, but three had persistent symptoms. In our study, the symptoms of children with HIHARS presenting with blank spells in isolation appeared to resolve spontaneously and did not evolve into convulsive seizures or other paroxysmal events considered to be clearly epileptic. Children (with HIHARS) who presented with clinical features suggestive of GTCS or focal motor seizures (with or without blank spells) and/or had epileptiform discharges on interictal electroencephalography were subsequently diagnosed with epilepsy.