Nöröfibromatozis Tip 1 ve Epilepsili Hastaların Klinik Karakteristikleri

Öz

Amaç: Epilepsi nörofi bromatozisli hastaların yaklaşık %4-7’sinde görülür. Bu oran genel popülasyon için yayınlanan %1-2’den yüksektir. Çalışmamızın amacı, NF1 ve epilepsili hastaların sonuçları ve klinik karakteristiklerini tanımlamaktır.Gereç ve Yöntemler: Bu çalışma için üçüncü basamak merkezimizde Ocak 2000 ve Şubat 2010 tarihleri arasında takip edilen 35 hasta değerlendirildi. Her hastaya elektrofi zyolojik ve nöroradyolojik inceleme yapıldı.Bulgular: NF1’li hastaların %34.2’sinde en az bir nöbet, %17.1’inde epilepsi öyküsü vardı. Jeneralize nöbetlerde görülmesine rağmen, fokal nöbetler hastaların %66’sında meydana gelen en sık nöbet tipiydi. Epilepsi 2 hastada serebral hamartomla, 3 hastada tanımlanamayan parlak objeler şeklinde beyin lezyonları ile görüldü. Nöbetler 3 hastada (%50) tek antiepileptik, 3 hastada (%50) multiple antiepileptik ile kontrol edildi.Sonuç: Bizim gözlemlerimiz ve bizim bulgularımızla literatürün tekrar incelenmesi bize NF1’li hastalarda intrakranial lezyonla ilişkili epilepsi riski olduğunu gösterdi. Nöbetler kortikal lezyonların ya da bir tümörün ilk semptomu olabilir. Biz nöbeti olan NF1’li hastalarda hastaların radyolojik takibinin göz önünde bulundurulması gerektiğini düşünüyoruz.

Anahtar Kelimeler

• Çocuk, Epilepsi, Nöbetler, Nörofi bromatozis Tip 1

Epilepsy Clinical Characteristics of Patients with Neurofi bromatosis Type 1 and Epilepsy

Öz

Objective: Epilepsy occurs in approximately 4-7% of individuals with Neurofi bromatosis type 1 (NF1). This is higher than the 1-2% value reported for the general population. The aim of the study was to describe the clinical characteristics and outcomes of individuals with NF1 and epilepsy.Material and Methods: This study evaluated 35 patients who were followed up for NF1 at our tertiary care center between January 2000 and February 2010. Every patient underwent electroencephalographic examination and neuroimaging investigations.Results: A history of at least one unprovoked seizure was present in 34.2% of NF1 patients and 17.1% had documented epilepsy. Focal seizures were the most common type, occurring in 57% of individuals, although generalized seizures were also noted. Epilepsy presented with brain lesions such as cerebral hamartoma in two patients and unidentifi ed bright objects in three patients. Seizures were controlled with a single antiepileptic drug in three (50%) and multiple antiepileptic drugs in three (50%) patients.Conclusion: Our observations and our re-evaluation of the literature indicate that patients with neurofi bromatosis 1 have an increased risk of epilepsy related to intracranial lesions and seizures can represent the fi rst symptom of a tumor or cortical lesions. We conclude that radiological follow-up should be considered in NF1 patients with seizures

Anahtar Kelimeler

• Child, Epilepsy, Seizures, Neurofi bromatosis type 1

Kaynakça

1. Friedman JM, Gutmann DH, MacCollin M, Riccardi VM. Neurofi bromatosis: Phenotype, natural history, and pathogenesis. Baltimore, MD: Johns Hopkins, 1999.
2. Friedman JM, Birch PH. Type 1 neurofi bromatosis: A descriptive analysis of the disorder in 1.728 patients. Am J Med Genet 1997;70:138-43.
3. Rodriguez FJ, Perry A, Gutmann DH, O’Neill BP, Leonard J, Bryant S, et al. Gliomas in neurofi bromatosis type 1: A clinicopathologic study of 100 patients. J Neuropathol Exp Neurol 2008;67:240-9.
4. Hsieh HY, Fung HC, Wang CJ, Chin SC, Wu T. Epileptic seizures in neurofi bromatosis type 1 are related to intracranial tumors but not to neurofi bromatosis bright objects. Seizure 2011;20:606-11.