摘要
目的探讨甲状腺功能亢进症（甲亢）伴癫癎样发作的临床特点及发病机制。方法总结本院2例住院甲亢患儿,均为女童。1例3岁7个月患儿出现高代谢症状9个月余,未给予正规治疗出现抽搐发作;另1例12岁患儿已诊断甲亢并口服抗甲亢药物,症状好转后自行停药,1周后出现抽搐发作。2例患儿的发作形式均为全面性强直-阵挛发作。根据患儿临床表现、实验室检查、治疗及转归,同时回顾性分析PUBMED检索及中文医学期刊全文数据库,从1975年至今国内外相关文献报道共18例甲亢伴癫癎样发作患儿（年龄3-18岁;男7例,女11例）。结果甲亢伴发癫癎样发作形式主要为全面性强直-阵挛发作,共18例;2例青春期患者表现为肌阵挛发作。其中有3种临床表现形式：8例（8/20例,占40%）以癫痫样发作为首发症状,分别在首发症状出现1个月-2a才确诊为甲亢;癫痫样发作为继发症状9例（9/20例,占45%）,在确诊为甲亢2个月-4a出现癫痫样发作,多为甲亢控制欠佳或中断药物时发生;癫痫患者并甲亢时癫痫样发作加重3例（3/20例,占15%）,均在青春期合并甲亢时发作次数明显增加。结论甲亢可引起癫痫样发作,其发作与甲状腺激素水平升高关系密切;甲亢与癫痫可能存在某些共同的免疫发病机制。
Objective To explore the clinical characteristics and pathogenesis of hyperthyroidism in children with epileptic seizures. Methods Two cases from our hospital were reported. One gM, aged 3 years and 7 months, had high metabolism symptoms for 9 months. She didn＇t take any medicine and seizure attacked her. The other girl, aged 12 years old, had diagnosed as hyperthyroidism and taken anti - hyperthyroidism medicine. Since her symptoms got better, she quitted the medicine by self -determining and one week later, her seizure attacked and the seizure type in 2 cases were generalized tonic - clonic seizure. According to their clinical manifestation,laboratory diagnosis, treatment and prognosis of diseases and other 18 cases, aged 3 - 18 years old,male 7 cases,female 11 cases, selected from searching databases of Medline and Chinese Medical Magazine since 1975 were retrospectively analyzed. The clinical characteristics and pathogenesis of hyperthyroidism with epileptic seizures were analyzed and reviewed. Results The main seizure type of hyperthyroidism was generalized tonic - clonie seizure （18 cases） ;2 cases with muscle- clonie seizure in puberty. There were three types of hyperthyroidism with seizures ：epileptic seizures as a primary symptom in hyperthyroidism （8/20 cases） and they were diagnosed from 1 month to 2 years after seizures;epileptic seizures as a secondary symptom in hyperthyroidism （9/20 cases） and they were diagnosed from 2 months to 4 yeats after hyperthyroidism, mostly happening at the cease of medicine or less curative effect; epileptic seizures worsen when complicating with hyperthyroidism （3/20 eases） and they attacked in puberty. Conclusions Hyperthyroidism can lead to the epileptic seizure, Epileptic seizures are highly related to hyper - thyroxin. The mechanism need to be further studied, Epilepsy and hyperthyroidism may have the same innnunological pathogenesis.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2008年第8期597-599,共3页
Journal of Applied Clinical Pediatrics
