Rasmussen 뇌염의 병기별 뇌파 소견
Electroencephalographic Features of Rasmussen's Encephalitis by Stage
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목적: Rasmussen 뇌염은 난치성 국소 간질, 진행하는 신경 장애 및 편측 대뇌 반구의 위축을 특징으로 하는 매우 드문 질환으로 전구기, 급성기, 잔류기의 자연 경과를 보인다 . 본 연구에서는 각 병기별로 특징적인 뇌파소견이 있는지 알아보고자 하였다 . 방법: 1997년부터 2012년까지 서울대병원 소아청소년과에서Rasmussen 뇌염으로 진단 된 환자들의 각 병기별 뇌파 소견을 배경파와 뇌전증모양파로 나누어 분석하였다 . 결과: 대상환자는 총 7명이었고, 평균 발병 연령은 6.7세(5.1 ~8.7 세), 전구기는 평균 21.4개월(1 ~55개월), 급성기 중간에 면역 치료나수술을 받은 환자를 제외한 3명의 환자에서 급성기는 평균 11.7개월(7~15개월)이었다. 전구기에서 급성기를 거쳐 잔류기로 진행하면서서파가 증가하고 광범위해지는 소견을 보였고, 급성기와 잔류기에서는 반대편에서 더 현저한 서파도 관찰되었다 .뇌전증모양파는 대부분의 환자에서 병기의 진행에 따른 변화 없이 국소성으로 관찰되었다 . 결론: Rasmussen 뇌염이 진행함에 따라 뇌파 소견은 서파가 광범위해지고, 반대편에서 더 현저한 서파를 보이기도 하였으나, 각 병기를 구별할 수있는 특징적인 소견은 보이지 않았다 .
Abstract
Purpose: The purpose of this study was to describe the characteristic electroence phalographic features in Rasmussen’s encephalitis by stage. Methods: Patients diagnosed with Rasmussen’s encephalitis at Seoul National University Children’s Hospital were retrospectively assessed. We analyzed the background activities and epileptiform discharges from electroencephalography(EEG) findings to identify the characteristic EEG features by stage. Results: Seven patients were included in the study. The mean age of first seizure onset was 6.7 years, and the mean duration of the prodromal phase was 21.4 months. During disease course, background activities, such as slow waves, were more prominent and diffuse, and contralateral slow waves were observed. In most patients, focal epileptiform discharges were observed during all stages without change. Conclusion: As Rasmussen’s encephalitis progresses, background abnormalities in the affected hemisphere increased, and contralateral slow waves occurred. However, characteristic EEG findings that were distinguishable at each stage were not observed.
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