1.Clinical analysis of post-stroke epilepsy in children
Qiongxiang ZHAI ; Zhihong TANG ; Yuxin ZHANG ; Chun WANG ; Muqing ZHUO
Chinese Journal of Applied Clinical Pediatrics 2014;29(7):533-535
Objective To analyze the clinical features,treatment and prognosis of children with post-stroke epilepsy.Methods Sixty-nine children with epilepsy after cerebral stroke who were admitted to Guangdong General Hospital from Jan.2009 to Mar.2013 were retrospectively reviewed,including etiology,clinical features,laboratory examinations,treatment and prognosis.Results Among 260 stroke patients,69 of them (26.5 %) developed epilepsy,but there was no significant difference between boys and girls(x2 =0.725,P =0.394).The incidence of post-stroke epilepsy differed significantly among different types (x2 =12.000,P =0.02),highest in the children with subarachnoid hemorrhage(47.8%,11/23 cases),followed by those with cerebral hemorrhage (34.6%,27/78 cases),and lastly,those with cerebral ischemia (19.5%,31/159 cases).Among them,53 patients developed seizures in the early stage (76.8%,53/69 cases),others in the late stage(23.2%,16/69 cases),early-onset epilepsy was more common in hemorrhagic stroke and late-onset epilepsy was more common in ischemic stroke,which differed significantly(x2 = 4.778,P =0.029).The electroencephalogram background generally showed slow-wave in the early-onset epilepsy.The composition of seizure types differed significantly among different types of stroke (x2 =8.461,P =0.015).Forty-five of 58 patients (77.6%) suffered from cortical lesions and 13 of 58 patients (22.4%) suffered from subcortical lesions.Those children with post-stroke epilepsy who regularly use of antiepileptic drugs were followed up for 6 months to 4 years,81.2% (56/69 cases)of clinical seizures were controlled.Conclusions The incidence of epilepsy after stroke is higher in children than in adults,cerebral stroke seizure occurs more commonly in cases with hemorrhagic stroke,especially with subarachnoid hemorrhage.Conventional antiepileptic treatment is effective.
2.The clinical feature and prognosis predictors associated with outcome for convulsive status epilepticus children
Qiongxiang ZHAI ; Huici LIANG ; Jian DING ; Yuxin ZHANG ; Yin HAO
Chinese Journal of Emergency Medicine 2009;18(7):728-731
Objective To investigate the clinical manifestation of convulsive status epilepticus (CSE) associated with the outcome of children contracted this illness in order to make an effort to prevent and treat those children. Method The patients with CSE admitted from October 1998 to October 2008 were prospectively and consecutively enrolled. All the patients met the diagnostic criteria set by International Anti-epilepsy Union (ILAE) in 1993. The prognosis predictors of outcome were analyzed with the Rank sum test, Chi-square analysis and Logistic regression analysis. Results A total of 169 patients with CSE were enrolled. Of them, 92 patients were from rural areas (54.4% ). The primary cause was central nervous system infection, and the minor ones were a reduction of dose or withdrawal of the antiepileptics, and cerebral hemorrhage. The duration of CSE before treatment was longer in rural patients than in urban residents ( P < 0.01) . The duration of CSE before treatment and the total persistence time of CSE was significantly associated with the mortality 14.2% . The source of patients, the duration before treatment, and respiratory depression were independent prognostic predictor variables of CSE (P < 0.05) .Conclusions The rural patients account for the major ratio of convulsive status epilepticus. Central nervous system infection is the primary cause. The duration before treatment and total persistence time of CSE are highly related to the mortality and morbidity.
3.Correlation between cerebral glucose metabolism and all sorts of paediatric epilepsy or seizure frequency
Qiongxiang ZHAI ; Huiling YANG ; Suzhen CAO ; Jian DING ; Huixian QIAO ; Yunbao PAN
Chinese Journal of Pathophysiology 2000;0(08):-
AIM:To investigate the correlation between cerebral glucose metabolism and paediatric epilepsy or seizure type and seizure frequency.METHODS:To observe the cerebral glucose metabolism in epileptogenic focus,18F-FDG positron emission computed tomography(PET) brain imaging tests were carried out in 86 cases of paediatric epilepsy diagnosed by EEG and MRI.RESULTS:Compared to control group,significantly statistical differences between children epilepsy group and control group in PET brain imaging were observed(P0.05) was observed.CONCLUSION:Cerebral glucose metabolism of paediatric epilepsy is abnormal.The abnormal PET with varieties of epilepsy is found in different brain district.There is positive correlation between the abnormal intensity of PET imaging and the severity or seizure frequency of epilepsy.
4.Therapeutic effect of levetiracetam add-on treatment for frontal lobe epilepsy in 105 children.
Yuxin ZHANG ; Qiongxiang ZHAI ; Zhihong TANG ; Muqing ZHUO
Journal of Southern Medical University 2014;34(3):364-367
OBJECTIVETo study the changes in 24-hour video electroencephalogram (EEG) and epileptic attacks after levetiracetam add-on therapy in children with frontal lobe epilepsy and epileptiform discharges.
METHODSA prospective study was carried out in 105 children with the frontal lobe epilepsy who received long-term treatment with 1 or 2 types of antiepileptic drug but still with epileptiform discharges in ECG. Levetiracetam add-on therapy was administered at the initial daily dose of 20 mg/kg (given in 2 doses) for 2 weeks followed by an increase of the dose to 30 mg/kg with a maintenance dose of 30-40 mg/kg. The changes in seizure attacks and 24-hour video-EEG monitoring after a 6-month therapy were observed.
RESULTSLevetiracetam add-on therapy reduced epileptiform discharges in 55 children (52.3%) and resulted in significant changes in EEG (P<0.05). Of the 77 children with clinical seizures, complete seizure control was achieved in 12 cases after the therapy, and the seizure attacks were reduced in 28 cases, showing a total response rate of 51.9%; the reduction in seizure attacks was positively correlated with EEG improvement (P<0.001).
CONCLUSIONLevetiracetam add-on therapy can decrease epileptiform discharges in EEG and reduce clinical seizure attacks in children with frontal lobe epilepsy with only mild adverse reactions.
Adolescent ; Anticonvulsants ; administration & dosage ; therapeutic use ; Child ; Child, Preschool ; Electroencephalography ; Epilepsy, Frontal Lobe ; drug therapy ; physiopathology ; Female ; Humans ; Infant ; Male ; Piracetam ; administration & dosage ; analogs & derivatives ; therapeutic use ; Prospective Studies ; Treatment Outcome