抗癫痫药物对儿童临床下痫性电持续状态及认知功能的影响  

Effects of AEDs on subclinical electrical status epilepticus and cognitive function of chil- dren

作　　者：张翠荣 龚德山 尚丽 刘珩 郭辉 王开颜[2] 

机构地区：[1]上海德济医院神经内科,上海200331 [2]复旦大学附属华山医院神经内科,上海200331

出　　处：《癫痫与神经电生理学杂志》2016年第2期73-76,共4页Journal of Epileptology and Electroneurophysiology(China)

摘　　要：目的：探讨抗癫痫药物（AED）对临床发作已控制，但脑电图（EEG）上仍存在癫痫性电持续状态ESES患者的认知功能的影响。方法：收集2013年3月～2015年11月本院门诊、住院治疗的儿童癫痫患者，用日本光电9000型长程录像脑电图（v-EEG）监测到的16例临床下ESES患者，临床无发作均超过半年，随访观察，调整治疗方案前后均再进行神经心理学评估和V-EEG监测。结果：16例应用卡马西平（CBZ）、奥卡西平（OXC）临床发作均已得到控制，V-EEG提示仍存在ESES现象，神经心理学评估均存在不同程度的认知功能障碍，治疗方案调整为丙戊酸钠／丙戊酸镁、左乙拉西坦／托吡酯，3个月后复查V-EEG提示ESES消失，脑功能状态得到改善（p〈0．05）。结论：AED的治疗目的，不仅要控制临床发作，也要控制临床下痫样放电，特别是ESES现象。Objective：To explore the effects of AEDs on subclinical electrical status epilepticus and cognitive function in children patients. Methods： Sixteen children out-patients and in-patients with epilepsy were analyzed from March 2013 to November 2015 in our hospital,who were free of clinical seizures for more than half a year. And were monitored electrical status epilepticus during sleep （ESES）with Japan photoelectric 9000 long-range video electroencephalogram（V-EEG）,and then received follow-up observa- tion. The neuropsychologieal assessment and long-term V-EEG examination were performed before and after drug treatment. Results：The clinical seizures of 16 cases were controlled with carbamazepine/oxcar- bazepine（CBZ/OXC）effectively. There existed electrical status epilepticus during sleep and cognitive dys- function of different degreesoin in the cases. Then the treatments were adjusted to sodium valproate / magnesium valproate/ levetiracetam/topiramate three months later and their ESES disappeared and brain function was improved（P〈0.05）. Conclusion： The aim of antiepileptic drug treatment is to control not only clinical attacks,but also clinical epileptiform discharge,especially the ESES of children patients with epilepsy.

关 键 词：抗癫痫药物(AED) 临床下癫痫性电持续状态(ESES) 认知功能 

分 类 号：R971.6[医药卫生—药品] R741.044[医药卫生—药学]