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Yıl:1999; Cilt: 36; Sayı: 3>> Özet
Nöropsikiyatri Arşivi; 1999;36(3):154-158
Epileptik düşme nöbetleri ve iyi seyirli çocukluk çağı epilepsileri
A Gökyiğit, B Baykan, C Gürses, A Çalışkan
i. Ü. İstanbul Tıp Fakültesi Nöroloji Anabilim Dalı
Giriş: Çocukluk çağının epileptik düşme nöbetleri (EDN) genellikle tedaviye dirençlidirler ve kötü bir prognozun habercisi sayılırlar. Olgular ve Yöntem: Başlangıçta sık EDN gösteren, izleyen yıllarda tama yakın düzelen atipik seyirli 4 epilepsi olgusunun klinik ve EEG özellikleri retro-spektif olarak değerlendirilmiştir. Bulgular: Nöromotor gelişimi normal olan 3 erkek, 1 kız olguda düşme nöbetleri 2.5-8 yaş arasında baş­lamıştır. EEG'lerde 2 olguda yaygın yavaş aktivite ile jeneralize yavaş diken-dalga deşarjları (YDD), bir ol­guda ise devamlı ve yaygın YDD deşarjları bulun­muştur. Bir olguda EEG normal sınırlarda olarak kaydedilmiştir. Başlangıçta Lennox-Gastaut sendro-mu, miyoklonik as ta tik epilepsi, atipik absans sta­tüsü ve smıfiandınlamayan jeneralize epilepsi tam­larını alan olgularda aktif epilepsi süreci 6 ay - 3 yıl sürmüştür. Son kontrolde yaşlan 16 ve 19 arası olan olgular 6 - 14 yıl süreyle remisyon göstermiş­lerdir. Bir olgu 12 yıl sonra jeneralize konvülziyon geçirmiştir. Bir olguda EEG normale dönmüş, 3 ol­guda temel aktivite normal bulunurken kısa süreli DD deşarjları görülmüştür.
Sonuç: Olgularımız başlangıçta klinik ve EEG bul­gularıyla kötü bir prognozu telkin etmiş ancak belir­gin düzelme göstermişlerdir. Bu olguların sınıflama­daki yerleri tartışmalıdır.
Epileptic Falls And Benign Childhood Epilepsies
Introduction: Epileptic falls during childhood are generally resistant to treatment and are considered as an indicator of a poor prognosis. Case Reports and Methods: The clinical and EEG features of 4 patients with frequent epileptic falls, which showed remission in the follow-up, were eva­luated retrospectively.
Results: There were 1 female and 3 male patients with a history of normal neuromotor development. Epileptic falls had started between 2.5 and 8 [year]s of age. The EEG's showed generalized slow activity with slow spike and wave (SSW) discharges in 2 ca­ses, generalized and continuous SSW paroxysms in one patient. The EEG was within normal range in the other patient. The initial diagnoses were Len­nox-Gastaut syndrome, myoclonic-astatJc epilepsy, atypical absence status epüepticus and unclassified generalized epilepsy. In these patients, active peri­ods of epilepsy lasted 6 [month]s to 3 [year]s. When they were last seen, their ages were between 16 and 19 and the remission periods had lasted for 6-14 ye­ars. In one of the patients, a generalized convulsion was observed after remission lasting 12 [year]s. In one patient, the EEG was normal at the end of the follow-up period. The EEG's of the remaining 3 ca­ses showed brief generalized spike and wave disc­harges on a normal background activity. Conclusion: Although our cases suggested a poor prognosis with epileptic falls and initial EEG fin­dings, they were underwent a long remission period. The classification of the epileptic syndromes of our cases remains questionable.

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