高热惊厥持续状态增加海马损伤的风险
2012-08-19 16:52:10   来源： 丁香园   作者：  评论：0 点击：

1，Children withfebrile status epilepticus (FSE) are at risk for hippocampal injury and showabnormalities in the development of this brain area, show findings from aprospective multicenter study.

1，来自一项多中心回顾性研究的结果显示，儿童处于高热惊厥持续状态（FSE）可能会增加海马损伤的风险及该大脑区域的发育异常。

2，In a commentaryaccompanying the report in Neurology, Michel Berg (University of Rochester, NewYork, USA) says the findings from the Consequences of Prolonged FebrileSeizures in Childhood (FEBSTAT) study suggest that both recurrent seizures andunderlying hippocampal abnormalities are mechanisms involved in subsequenthippocampal sclerosis and the development of mesial temporal lobe epilepsy, butoccur independently rather than synergistically.

2，在Neurology杂志发表的一篇对上述 研究的评论中，纽约罗彻斯特大学的Michel Berg提到，儿童长期高热惊厥与预后（FEBSTAT）研究的结果显示，反复发作的惊厥与潜在的海马区异常是参与继发海马区硬化和形成颞叶癫痫的机制， 但两者是独立作用的，而非协同作用。

3，In total, 11.5%(n=22) of the 191 children (aged 1 month to 5 years) who presented with FSElasting a median of 71.7 minutes showed abnormal increased T2 signal in thehippocampus following FSE compared with none in the control group.

3，在所有1月至5岁之间，高热惊厥平均持续时间为71.7分钟的191名儿童中，有11.5%（22名）在出现高热惊厥持续状态后显示海马区T2信号异常增高，而对照组则无该表现。

4，Abnormal T2 signalwas present in the adjacent temporal lobe, amygdala, or insula in 27% of the 22children with abnormal hippocampal T2 signal compared with none of thecontrols.

4，在22名出现海马区异常信号的儿童中，有27%的儿童异常的T2信号出现在相邻的颞叶、杏仁核或岛叶。

5，Shlomor Shinnar(Columbia University, New York, USA) and colleagues also found thatdevelopmental abnormalities of the hippocampus were more common among childrenwith FSE (10.5%) than controls (2.1%), with hippocampal malrotation the mostcommonly occurring abnormality.

5，纽约哥伦比亚大学的ShlomorShinnar及同事同样发现，出现高热惊厥持续状态的儿童中10.5%出现海马区异常，这与正常对照组2.1%的发生率相比更常见，而海马旋转不良是最常见的。

6，However, 67.0% ofchildren did not show visible brain abnormality (either acute or developmental)on magnetic resonance imaging (MRI) within 3 days of FSE, suggesting thatcurrent MRI technology may not be adequate for identifying pathologic processesin some individuals.

6，然而，有67.0%的儿童在高热惊厥持续状态发生后3天内，脑部MRI均未显示可见的急性或进行性的异常，这提示目前的MRI技术或许还不足以发现某些患者的病理性改变。

7，Electroencephalogram(EEG) may be a useful tool for differentiating children at risk for laterepilepsy, since focal EEG slow activity was associated with hippocampal T2signal abnormalities but not with hippocampal developmental abnormalities.

7，脑电图（EEG）或许是鉴别患儿是否会继发癫痫的更好方式，因为局灶性的脑电图慢活动与海马区T2信号异常有关，而与海马区发育异常无关。

8，Overall,extrahippocampal abnormalities did not appear to differ between children withFSE and controls. However, temporal lobe abnormalities were significantly morecommon in FSE cases.

8，总而言之，海马区的其他异常表现在高热惊厥持续状态的患儿与对照组之间并未显示有差别。然而，颞叶异常在高热惊厥持续状态的患儿中更常见。

9，No risk factorspredictive for abnormal hippocampal T2 signal were identified in the study.

9，该研究中未发现能预测海马区异常T2信号的危险因素。

10，The researchers notethat the absence of an association between seizure duration and risk forhippocampal injury could be a result of the study being restricted to FSE andseizures occurring for long periods of time.

10，研究者指出，或许由于该研究仅限于高热惊厥持续状态和惊厥持续时间较长的患儿，因此未能发现惊厥持续时间和海马区损伤风险之间的联系。

11，In addition, thelack of an association with duration and focality could also be a result ofincluding only children with FSE.

11，此外，或许因为仅纳入了出现高热惊厥持续状态的患儿，因此未发现惊厥持续时间和局灶性改变之间的联系。

12，"The data from theFEBSTAT study demonstrate that there is MRI evidence of acute hippocampalinjury following FSE in a substantial minority of children. This does not implythat the other children have not sustained a more subtle injury. Ongoingfollow-up of the FEBSTAT cohort is in progress," say Shinnar and team.

12，Shinnar及其研究小组称，“来自FEBSTAT研究的数据证明，在少数儿童中，出现高热惊厥持续状态后MRI显示急性海马损伤。而这并不意味着可以排除其他患儿有更微小的持续性的损害。FEBSTAT队列研究的随访还在继续进行。”