1、 Analysis of hemiconvulsion hemiplegia epilepsy syndrome（浅析偏侧惊厥-偏瘫- 癫痫综合征）Laterality of seizures after persistent hemiplegia called laterality convulsion - hemiplegia syndrome ( HH ) is often accompanied by fever, convulsions. Like the later onset of epilepsy, is called a hemiplegia a laterality con
2、vulsion epileptic syndrome ( HHE ). HHE from Gastaut is equal to the first reported in 1957, but this phenomenon has been known in clinical.偏侧惊厥后出现持续偏瘫称为偏侧惊厥-偏瘫综合征(HH)，惊厥常伴有发热。如以后发生癫痫，则称为偏侧惊厥一偏瘫一癫痫综合征(HHE)。HHE 由 Gastaut 等于 1957 年首次报道，但这一现象在临床早已被认识。The disease incidence is unknown. According to the p
3、erceived morbidity decreased gradually. According to Chauvel to Et relative to area from 1967 to 1978 epidemiology, population under 5 years of age the incidence has declined to 7.77 per million people from 1.64. But in the developed countries or regions may still higher.本症发病率尚不清。据认为发病率呈逐渐下降趋势。根据 Ch
4、auvel 等对 Et 内瓦地区19671978 年的流行病学调查，5 岁以下人群的发病率已从每万人 777 下降到 164。但在不发达国家或地区可能仍然较高。【 Etiology】【病因学】1。 symptoms of HHE etiology is often acute progression of lesions of the central nervous system, such as encephalitis, meningitis, subdural hematoma or vascular injury, often accompanied by primary diseas
5、e caused by neurological symptoms and signs. In some cases the etiology is not clear. Others think that venous thrombosis is HHE common etiology, mainly from the facial infection ( tonsillitis, otitis media ) cause, often with febrile seizures.1症状性 HHE 病因常为急性进展的中枢神经系统病变，如脑炎、脑膜炎、硬膜下血肿或血管损伤等，常伴有原发病引起的
6、神经系统症状和体征。有些病例病因不明确。也有认为静脉血栓是 HHE 常见的病因，主要由头面部感染 (扁桃体炎、中耳炎等)引起，常伴热性惊厥。2、Idiopathic HHE febrile convulsion by infection of the central nervous system ( for general infection caused by hemiplegia ), clinical divide outside without other neurological abnormalities, laboratory and radiologic examination
7、s without specific found. Late seizures are often associated with hippocampal sclerosis associated with hippocampal sclerosis, but early febrile convulsion causation remains controversial.2特发性 HHE 热性惊厥由非中枢神经系统感染 (多为一般感染)所致，临床除偏瘫外无其他神经系统异常，实验室和影像学检查无特异性发现。后期的癫痫发作常与海马硬化有关，但海马硬化与早期热性惊厥的因果关系仍有争论。【Diagno
8、sis and differential diagnosis 】【诊断与鉴别诊断】According to the infantile repeated or long time to laterality clonic consisting mainly of febrile seizures, and seizures after persistent hemiplegia, can make a diagnosis of HH syndrome. If after the afebrile convulsion, especially in medial temporal lobe ep
9、ilepsy, can be diagnosed as HHE syndrome. Imaging examination is helpful to find the cause.根据婴幼儿期反复或长时间以偏侧阵挛为主的热性惊厥，伴发作后持续偏瘫，可作出HH 综合征的诊断。如以后出现无热惊厥，特别是内侧颞叶癫痫，则可诊断为 HHE 综合征。影像学检查有助于发现病因。This disorder should be associated with pediatric alternating hemiplegia of differential. The latter is usually no
10、fever and seizures, hemiparesis are alternately repeated seizures, ictal EEG without epileptiform discharges, antiepileptic therapy is ineffective, can be distinguished.本症应与小儿交替性偏瘫鉴别。后者一般无发热及惊厥，偏瘫多为反复交替性发作，发作期 EEG 无痫样放电，抗癫痫治疗无效，可资鉴别。【 Treatment and prognosis】【治疗和预后】This sickness treatment is the key
11、 to control persistent febrile seizures, especially the lateralization clonic seizures, should be used as emergency treatment, as soon as possible to stop smoking, but through a vein or given rectal diazepam preparation, or rectal perfusion of chloral hydrate. Timely cooling and the corresponding an
12、ti infection treatment is also very important. Such as have muscle syndrome of febrile convulsion, preventive treatment, but some people think it does not prevent a later onset of epilepsy seizure. On epilepsy should be regular treatment with antiepileptic drugs. There is a clear hippocampal scleros
13、is or other epileptogenic lesion, and drugs in the treatment of uncontrollable seizures, may be considered for surgical operation treatment.本症治疗的关键是及时控制持续的热性惊厥发作，特别是偏侧阵挛性发作，应作为急诊处理，尽快给予止抽，可通过静脉或直肠给予安定制剂，或直肠灌注水合氯醛。及时降温和相应的抗感染治疗也很重要。如已出现肌综合征，可对热性惊厥进行预防性治疗，但有人认为这并不能防止以后出现癫痫发作。对癫痫应进行正规的抗癫痫药物治疗。有明确的海马硬化或
14、其他致痫病灶，且药物治疗不能控制发作时，可考虑外科手术治疗。Symptoms of HH and HHE syndrome the prognosis depends on the cause. The idiopathic cases, due to the recent emphasis on febrile convulsion in a timely and effective control, the development of HHE were significantly decreased than before.症状性 HH 和 HHE 综合征的预后取决于病因。对特发性病例，由于近年来强调对热性惊厥及时有效的控制，发展为 HHE 的病例比以前有明显减少。文章来源：http:/
