Etiologies and Etiological factors of Childhood Complex Partial Seizures of Temporal Lobe Origin

兒童顳葉源性複雜局部發作的病因與致病因子之探討

10.6440/TZUCMJ.200012.0209

王本榮(Pen-Jung Wang)；陳榮隆(Rong-Long Chen)；沈友仁(Yu-Zen Shen)

病因 ； 致病因子 ； 兒童顳葉源性複雜局部發作 ； etiologies ； etiological factors ； childhood complex partial seizures

慈濟醫學雜誌

12卷4期（2000 / 12 / 01）

209 - 216

英文

目的：成人的顳葉源性複雜局部發作大多肇因於顳葉內側硬化，但在兒童則尚未有定論，本研究目的在更精確的探討兒童顳葉源性複雜局部發作之病因與致病因子。病人及方法：本研究的對象是33名合乎兩項選擇基準之病，包括（1）有反復性顳葉源性複雜局部發作及（2）核磁共振掃描檢查發現有明確之病灶在大腦葉。每一個病童都有完整之臨床資料、發展史、病史、神經學和理學檢查，對於可能的病因及致病因子本研究也都定設嚴密的定義。結果：8名病童被發現有顱內佔據性病灶及3名有先天性顳葉的形成不良。15名病童有顳葉內側硬化，其中13名單側硬化的病中8名有熱性抽筋的病史，而2名兩側硬化的病童都有癲癇重積症的病史。而在洞腦症及顳葉萎縮的病童似乎與產前或周產期的因素，如早產及窒息有關性。結論：本研究的結果支持兒童顳葉源性複雜局部發作，可由於許多病因所導致。

Objective: To more precisely explore the etiologies and etiological factors for childhood complex partial seizures (CPS) of temporal lobe origin. Patients and Methods: Thirty three epileptic children who had recurrent temporal lobe origin CPS with definite abnormal lesions confined to or mainly involving the temporal lobe as evidenced on magnetic resonance imaging (MRI) were studied. For each patient we gathered complete clinical data and performed detailed physical and neurological evaluations. The histories included direct questions about prenatal, perinatal and postnatal events and development, previous brain insults and seizures. Results: Eight patients were diagnosed with intracranial space-taking lesions including low-grade astrocytoma, leukemia, cerebral cysticercosis, dermoid cyst and, arachnoid cyst; and 3 patients had cortical dysplasia. Fifteen patients were documented to have mesial temporal sclerosis (MTS). Eight of 13 cases with unilateral MTS had a past history of febrile seizures, and 2 cases with bilateral MTS had a history of an episode of status epilepticus. Cases of porencephaly and global atrophyof the temporal lobe were highly related to prenatal or perinatal insults including preterm delivery and asphyxia. Conclusions: these results suggest that childhood CPS of temporal lobe origin can result from a wide variety of causes.