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Arquivos de Neuro-Psiquiatria

Print version ISSN 0004-282X

Arq. Neuro-Psiquiatr. vol.55 no.4 São Paulo  1997

https://doi.org/10.1590/S0004-282X1997000500013 

Espícula-onda contínua durante o sono: aspectos clínicos e eletrencefalográficos

 

Continuous spike-wave activity during sleep: clinical and electroencephalographical aspects

 

 

Laura M.F. Ferreira GuilhotoI; Lúcia R. Machado-HaertelII; Maria Luíza G. ManrezaIII; Aron J. DiamentIV

IDepartamento de Neurologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC/FMSUP): Médica Pós-graduanda
IIDepartamento de Neurologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC/FMSUP): Médica Residente
IIIDepartamento de Neurologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC/FMSUP): Médica Assistente

IVDepartamento de Neurologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC/FMSUP): Chefe da Seção de Neurologia Infantil

 

 


RESUMO

Dezessete crianças com espícula-onda contínua durante o sono foram estudadas retrospectivamente. Cinco apresentavam distúrbio da fala após desenvolvimento normal da linguagem e crises epilépticas (síndrome de Landau e Kleffner - grupo 1). Doze crianças tinham atraso do desenvolvimento neuropsicomotor e/ou deficiência mental (grupo 2). Crises epilépticas estavam presentes em 11 pacientes deste grupo, tetraparesia em 5, hemiparesia em 2, microcefalia em 2, distúrbios de comportamento em 4 casos. O eletrencefalograma mostrou em todos os casos espícula-onda contínua durante o sono. Pacientes do grupo 1 apresentavam atividade epileptiforme difusa com acentuação das descargas nas regiões temporais em 4 de 5 casos; e os do grupo 2, descargas difusas, incluindo atividade multifocal (5/ 12), por vezes com predomínio anterior (7/12). Concluímos que espícula-onda contínua durante o sono é um padrão eletrográfico inespecífico de certos tipos de epilepsia na infância com diferentes manifestações clínicas, que mostra no entanto certa diferenciação topográfica, de acordo com os prováveis sítios lesionais.

Palavras-chave: afasia adquirida, epilepsia, espícula-onda contínua durante sono lento.


ABSTRACT

Seventeen children were retrospectively evaluated. They exhibited continuous spike-wave activity during slow wave sleep (CSWS). Five of these had only speech problems and seizures (Landau-Kleffner syndrome) (group 1). The other cases had developmental milestones acquisition delay and/or mental retardation (group 2). Epileptic seizures were present in 11 of these, tetraparesis was observed in 5, hemiparesis in 2, microcephaly in 2 and behavior disturbances in 4 cases. The electroencephalogram showed in all cases diffuse CSWS. Group 1 showed diffuse activity, at times accentuated in the centrotemporal region (4/5). Group 2 had widespread discharges, including multifocal activity (5/12), sometimes with anterior predominance (7/12). We concluded that CSWS is a non specific electrographic pattern observed in some types of epilepsy in childhood that have different clinical presentation. It has however some topographic differentiation, depending upon the lesional sites.

Key words: acquired aphasia, epilepsy, continuous spike-wave during sleep.


 

 

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Full text available only in PDF format.

 

 

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Aceite: 19-agosto-1997.

 

 

Dra Laura M.F.F. Guilhoto - Departamento de Neurologia, Hospital das Clínicas, FMUSP - Av. Dr. Enéas de Carvalho Aguiar s/n - 05403-900 São Paulo SP - Brasil.

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