Abstract：
OBJECTIVE: To elucidate the incidence and outcomes of childhood-onset epilepsy and associated factors in term-born patients with basal ganglia and thalamic lesion (BGTL)-induced dyskinetic cerebral palsy (DCP) caused by perinatal hypoxic-ischemic encephalopathy (HIE).
METHODS: We studied 104 term-born patients with BGTL-induced DCP (63 males and 41 females, aged 2-22 years) to investigate the incidence of epilepsy and the factors related to its development. We used multivariate analysis to assess perinatal factors, gross motor function, and the extent of brain lesions. We also investigated the seizure onset, clinical course, and electroencephalography (EEG) characteristics.
RESULTS: The cumulative epilepsy incidence was 36%. Multiple logistic regression analysis revealed that deep white matter lesions were the only independent risk factor for epilepsy. The confirmed seizure types included epileptic spasms (ES, n = 13), myoclonic seizures (MS, n = 6), and focal-onset seizures (FS, n = 24). Only patients with deep white matter lesions exhibited ES or MS. The symptoms of FS resembled those of self-limited epilepsy with centrotemporal spikes; however, only half of the patients reached remission by the time of investigation, and four patients had more than one seizure per month despite appropriate drug therapy. Focal spikes in the peri-rolandic area were detected not only in patients with FS but also in half of the patients without epilepsy.
CONCLUSIONS: One-third of term-born patients with BGTL-induced DCP caused by perinatal HIE develop epilepsy, and deep white matter lesions increase the likelihood of epilepsy. Preparation for early-onset ES, MS, and subsequent FS is beneficial.
METHODS: We studied 104 term-born patients with BGTL-induced DCP (63 males and 41 females, aged 2-22 years) to investigate the incidence of epilepsy and the factors related to its development. We used multivariate analysis to assess perinatal factors, gross motor function, and the extent of brain lesions. We also investigated the seizure onset, clinical course, and electroencephalography (EEG) characteristics.
RESULTS: The cumulative epilepsy incidence was 36%. Multiple logistic regression analysis revealed that deep white matter lesions were the only independent risk factor for epilepsy. The confirmed seizure types included epileptic spasms (ES, n = 13), myoclonic seizures (MS, n = 6), and focal-onset seizures (FS, n = 24). Only patients with deep white matter lesions exhibited ES or MS. The symptoms of FS resembled those of self-limited epilepsy with centrotemporal spikes; however, only half of the patients reached remission by the time of investigation, and four patients had more than one seizure per month despite appropriate drug therapy. Focal spikes in the peri-rolandic area were detected not only in patients with FS but also in half of the patients without epilepsy.
CONCLUSIONS: One-third of term-born patients with BGTL-induced DCP caused by perinatal HIE develop epilepsy, and deep white matter lesions increase the likelihood of epilepsy. Preparation for early-onset ES, MS, and subsequent FS is beneficial.
摘要：
目的：探讨围产期缺氧缺血性脑病(HIE)所致基底节区和丘脑病变(BGTL)所致运动障碍型脑瘫(DCP)足月患儿儿童期发作癫痫的发生率、转归及相关因素。
方法：我们研究了104例足月出生的BGTL诱导的DCP患者（男性63例，女性41例，2-22岁），以调查癫痫的发生率及其发展相关因素。我们使用多变量分析来评估围产期因素，粗大运动功能，以及脑部病变的程度。我们还调查了癫痫发作，临床课程，和脑电图（EEG）特征。
结果：累积癫痫发生率为36%。多因素logistic回归分析显示，深部脑白质病变是癫痫的独立危险因素。确认的癫痫发作类型包括癫痫性痉挛(ES，n=13),肌阵挛性癫痫发作（MS，n=6),和局灶性发作性癫痫(FS，n=24）。只有深部白质病变的患者表现为ES或MS。FS的症状类似于具有中央颞部尖峰的自限性癫痫。但是，只有一半的患者在调查时达到缓解，尽管接受了适当的药物治疗，但4例患者每月癫痫发作一次以上。不仅在FS患者中，而且在一半的无癫痫患者中也检测到了rolandic周围区域的局灶性尖峰。
结论：三分之一的由围产期HIE引起的BGTL诱导的DCP的足月出生患者发展为癫痫，和深部白质病变增加了癫痫的可能性。早发性ES的准备，MS,和随后的FS是有益的。
方法：我们研究了104例足月出生的BGTL诱导的DCP患者（男性63例，女性41例，2-22岁），以调查癫痫的发生率及其发展相关因素。我们使用多变量分析来评估围产期因素，粗大运动功能，以及脑部病变的程度。我们还调查了癫痫发作，临床课程，和脑电图（EEG）特征。
结果：累积癫痫发生率为36%。多因素logistic回归分析显示，深部脑白质病变是癫痫的独立危险因素。确认的癫痫发作类型包括癫痫性痉挛(ES，n=13),肌阵挛性癫痫发作（MS，n=6),和局灶性发作性癫痫(FS，n=24）。只有深部白质病变的患者表现为ES或MS。FS的症状类似于具有中央颞部尖峰的自限性癫痫。但是，只有一半的患者在调查时达到缓解，尽管接受了适当的药物治疗，但4例患者每月癫痫发作一次以上。不仅在FS患者中，而且在一半的无癫痫患者中也检测到了rolandic周围区域的局灶性尖峰。
结论：三分之一的由围产期HIE引起的BGTL诱导的DCP的足月出生患者发展为癫痫，和深部白质病变增加了癫痫的可能性。早发性ES的准备，MS,和随后的FS是有益的。
