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《Chinese Journal of Practical Pediatrics》 2012-01
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The treatment and prognosis of myoclonic atonic epilepsy

DENG Jie,ZHANG Yue-hua,YANG Zhi-xian,LIU Xiao-yan,XIONG Hui,WANG Shuang,JIANG Yu-wu,QIN Jiong,Wu Xi-ru.Department of Pediatrics,Peking University First Hospital,Beijing 100034,China  
Objectives To summarize the treatment,EEG evolution and prognosis of myoclonic atomic epilepsy(MAE),and to provide a reference for selection of treatment program and evaluation of prognosis.Methods MAE patients were diagnosed in Pediatric Department of Peking University First Hospital from November 2005 to December 2010.The treatment effects,EEG evolutions,and prognosis of MAE patients were followed up.Results In 48 MAE patients,41 were male and 7 were female.The patients were followed up from 8 months to 5 years and 5 months.Seizures were controlled by antiepileptic drugs(AEDs)in 42 patients(87.5%).The AEDs included valproate(38 cases),lamotrigine(25 cases),levetiracetam(10 cases),clonazepam(9 cases),and topiramate(8 cases).The seizures of 2 patients were controlled by adrenocorticotropic hormone(ACTH).In 44 seizure-free patients,the interictal generalized spike and wave discharges(GSWDs)disappeared in 36 patients in their course of 7 to 49 months,the EEG returned normal in 30 patients in their course of 7 to 44 months,θ rhythm existed in 6 cases.Cognitive decline were observed in 11 cases(22.9%).Status epilepticus,tonic seizures,uncontrolled seizures,and continuous EEG discharges were associated with cognitive decline.Conclusion Valproate and lamotrigine are more effective on MAE compared with other AEDs.After seizures have been controlled,the interictal GSWDs disappear first,and the background θ rhythm disappear later.The majority of MAE patients obtain a better prognosis by rational choice of AEDs for the treatment.
【CateGory Index】: R742.1
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