小児癲癇—その成因並びに熱性痙攣との関係について

Epilepsy in Childhood: Its Etiology and Clinical Correlation with Febrile Convulsion

I．緒言

　癲癇に関する研究は古くから数多く行われ，更に脳波学の応用，脳外科学的知見の集積によつて近年，飛躍的発達を遂げたが，今なお未解決の点が極めて多い。

　小児期の癲癇については，Lennox^1）2），Gibbs^3）4），Bridge^5），Livingston^6），Peterman^7），Zellweger^8），Janz及びMatthes^9）等多数の勝れた研究がなされているが，本邦においては，学童期以後を対象とする報告が多く^{10）11）12）}，特に小児の癲癇の多数例を取扱つた研究は比較的少い。今迄に多数の小児を対象とした臨床的研究は，菅野氏^13），小林氏^14），桂教授^15），遠城寺教授等^16），伊藤氏^17）及び飯尾氏等^18），鴇田氏等^18）の報告があり，それぞれ勝れた業績を上げているが，なお外国に比すればその症例も少く，我が国における小児の癲癇の全貌を把握するには至つていない。

The causes of epilepsy of 805 patients whodeveloped the symptomes under twelve yearsold were discussed. In 15% of the total cases, the cerebral damages at birth were consideredas the important causative factors, concluded fromthe comparison with 2,000 normal subjects, and in12%, postnatal cerebral damages such as encephalitis, acute vascular disorders or trauma playedthe important role. Ninty nine cases had the history of febrile convulsions. They showed higherhereditary tendency to febrile convulsion thanthe epileptic children without the history of febrile convulsion. The formes of epilepsy of 94cases with the history of febrile convulsion wereobserved both clinically and electroencephalographically, and 39% of the cases were detectedto have focal seizures. Therefore, the perinatalor prenatal cerebral damages due to febrile convulsion were considered to play a significantrole in the development of epilepsy in thosecases. Absence with the typical 3c/s spike andwave disharge were found in 8 cases. In thesecases, the febrile convulsion would be consideredas a manifestation of centrencephalic seizures.