儿童良性癫痫伴中央颞区棘波的不典型表现  

Atypical presentations of benign childhood epilepsy with centrotemporal spikes

作　　者：李婧[1,2] 李保敏[1,2] 雷革非[1,2] 贾桂娟[1,2] 童丽丽[1,2] 王纪文[1,2] 

机构地区：[1]山东大学齐鲁医院儿童医疗中心 [2]山东大学脑科学研究所,济南250012

出　　处：《山东大学学报（医学版）》2013年第7期42-44,49,共4页Journal of Shandong University:Health Sciences

基　　金：山东省泰山学者建设工程专项(TS20110814)

摘　　要：目的探讨儿童良性癫痫伴中央颞区棘波(BECT)的不典型临床表现、脑电图特点、治疗及预后。方法收集2006年12月至2012年7月在齐鲁医院就诊的122例BECT患儿的临床资料,对病程中出现不典型症状的11例BECT患儿进行动态脑电图或视频脑电图监测,并对其发作时的表现、神经心理学损伤及对抗癫痫药物治疗的反应进行分析和随访。结果 11例患儿病程中均出现发作形式的改变或脑电图恶化。2例丙戊酸钠治疗有效,4例丙戊酸钠加氯硝西泮治疗有效,3例托吡酯治疗有效。2例经多种抗癫痫药物治疗后,仍存在睡眠期脑电图癫痫性电持续状态。结论 BECT存在不典型表现,病程中可出现不同的发作形式,同时伴有脑电图的恶化及认知行为等方面的缺陷,发作相对难以控制。Objective To explore the atypical clinical presentation, electroencephalography characteristics, treatment and prognosis of benign childhood epilepsy with centrotemporal spikes （BECT）. Methods We collected the clinical data of 122 BECT children who were treated in Qilu Hospital of Shandong University from September 2006 to July 2012. Ambulatory or video electroencephalography monitoring was performed in 11 BECT children who had atypical symptoms screened from the above 122 children. The seizure semeiology, neuropsychological impairment and response to antiepileptic drugs were analyzed and followed up in the 11 children. Results All of the 11 cases showed seizure changes or electroencephalography deterioration. Sodium valproate was only effective in 2 cases. Combination of sodi- um valproate and clonazepam was effective in 4 cases. Topiramate were effective in 3 cases. Electrical status epilepticus still existed during sleep after various antiepileptic drug therapy in 2 cases. Conclusion Atypical presentations and dif- ferent forms of seizure semeiology exist in BECT. The clinical presentations are associated with electroencephalography deterioration and cognitive deficits, and the seizures are relatively difficult to control.

关 键 词：良性癫痫 不典型表现 儿童 中央颞区棘波 动态脑电图 

分 类 号：R729[医药卫生—儿科]