AEEG在伴有中央颞区棘波儿童良性癫癎诊治中的作用  

Value of ambulatory EEG on diagnosis and treatment of benign childhood epilepsy with centro-temporal spikes

作　　者：崔赛男[1] 谷丽[1] 

机构地区：[1]同济大学附属第十人民医院儿科,上海200072

出　　处：《同济大学学报（医学版）》2009年第5期97-99,103,共4页Journal of Tongji University(Medical Science)

摘　　要：目的探讨24 h动态脑电图（ambulatory electroencephalogram,AEEG）在伴有中央颞区棘波儿童良性癫癎（benign childhood epilepsy with centro-temporal spikes,BECT）诊治中的意义。方法对38例本病患儿的常规脑电图（regular electroencephalogram,REEG）和24 h AEEG进行分析比较,并随访治疗效果和脑电图（electroencephalogram,EEG）变化。结果本组发病年龄为2-14岁,38例发作均与睡眠密切相关,38例发作间期脑电图背景波正常,均有单侧或双侧中央和中颞区棘波或尖波。AEEG清醒期17例检出癎样波,睡眠期38例均检出癎样波,REEG仅5例检出癎样波,AEEG阳性率显著高于REEG（P〈0.01）,AEEG睡眠期阳性率显著高于清醒期（P〈0.01）。36例接受抗癫癎单药治疗后6个月内临床发作均消失,随访发现多数患儿AEEG恢复正常滞后于临床发作的停止。结论BECT临床发作和癎样波发放均与睡眠密切相关,发作间期脑电图呈特征性改变,AEEG对BECT的诊断至关重要。临床发作停止超过2年可以考虑逐渐减量停药,并密切随访临床发作与AEEG情况。Objective To investigate the value of ambulatory electroencephalogram （AEEG） on diagnosis and treatment of benign childhood epilepsy with centro-temporal spikes （BECT）. Methods The regular EEG （REEG） and 24 h-AEEG records of 38 cases were analyzed, and the therapeutic effect and EEG change were followed-up. Results Convulsions occurred mostly in 2 to 14-year-old children, and the clinic seizure of all 38 cases was closely related to sleeping. Interictal EEG background was normal and there were unilateral or bilateral central-temporal spikes and sharp waves in all 38 patients. Among them, 17 cases showed epileptiform discharges in awake stage, while all 38 cases showed epileptiform discharges in asleep stage in AEEG. However, only in 5 children epileptiform discharges were recorded in REEG. There were significant differences among 3 groups （P 〈 0.01 ）. Thirty-six patients were treated with single antiepileptic drug and all the patients were seizure-free within 6 months. Follow-ups discovered that AEEG normalization trailed behind the clinical seizure-free phase in most of these children. Conclusion BECT is closely related to sleeping, and interictal EEGs of 38 patients show unilateral or bilateral central-temporal spikes and sharp waves. The AEEG plays an important role in the diagnosis of BECT. Medication can be stopped even patients＇ EEGs still remain abnormal.

关 键 词：儿童良性癫癎 动态脑电图 诊断 治疗 

分 类 号：R742.1[医药卫生—神经病学与精神病学]