小児難治性てんかんのABRに関する研究 : 点頭てんかんを中心に
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概要
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The potentials, termed auditory brain stem response (ABR), are thought to be the far-field reflection of electrical events originating in the auditory pathway during its course through the brain stem. Children with intractable seizures and other diseases of the brain were investigated by measurement of ABR. The subjects- consisted of 21 cases of infantile spasms, 9 cases of the Lennox syndrome and 44 other cases (other types of epilepsy, brain tumor, etc.). Computed Tomography (CT) was also performed for almost all the subjects. ABR were estimated by latencies of wave 1, wave 5 and wave 5-1 interwave latencies at 80dBHL of 4KHz clicks. The results were compared with those of normal subjects. The brain stem lesion pattern (BSLP) shows the disappearance of some waves followed by wave 1 or prolonged latencies over 2 standard deviations from the mean for the normal subjects. (1) The relationship between CT and ABR was studied. In infantile spasms, 13/21 cases (62%) showed abnormal CT findings and 6/21 cases (29%) brain stem lesion patterns (BSLP) on ABR. All the latter 6 cases who showed BSLP were found to show abnormal CT findings. On the other hand, the subjects with normal ABR patterns were not always found to show normal CT findings. In the all subjects, 14 cases showed BSLP and almost all cases (13/14 cases) were found to show abnormal CT findings. It was supposed that BSLP was caused by the nature or the extension of the brain lesion. (2) After 2 years follow up period, the relationships between ABR and seizures and DQ (IQ) were studied. In infantile spasms, it was interesting that in the patients with BSLP, 4 cases (67%) had seizures and all 6 cases had mental retardation. On the other hand, it was found that in 15 cases with normal ABR patterns, 6 cases showed normal development, 5 had seizures and 9 had mental retardation. (3) Follow up ABR was examined in infantile spasms. Almost all the patients who showed BSLP on admission had normal ABR patterns. It is important in making a prognosis that ABR should be investigated at the onset of seizure in infantile spasms. We have studied ABR in a variety of neurological disorders, especially intractable seizures, and found them to be helpful in making a prognosis.
- 神戸大学の論文
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