睡眠中癫性电持续状态儿童的神经心理损伤

Neuropsychological Impairment of Children with Electrical Status Epilepticus during Sleep

目的探讨儿童睡眠中癫性电持续状态(ESES)的神经心理损伤。方法对本院2000年1月-2006年7月就诊的ESES患儿30例采用韦氏儿童智力量表-修正版(WISC-R)进行智力测验,选择发作频度、性别、年龄与ESES组相匹配的非ESES癫患儿30例作为对照组同时进行智力测验。各智力检测值以x-±s表示,采用SPSS11.5软件进行数据处理,二组间进行t检验。对ESES患儿进行精神行为异常分析,评价其神经心理损伤。结果ESES组与对照组智力测验比较,语言智商(VIQ)有显著性差异,操作智商(PIQ)除填图外均有显著性差异,总智商(FIQ)比较有显著性差异(t=-8.732,-8.637,-9.129Pa<0.05)。ESES30例中25例(83.3%)精神行为异常,其中语言障碍11例(36.7%),学习困难7例(23.3%),攻击行为4例(13.3%),注意力缺陷多动障碍3例(10.0%)。结论ESES对儿童智力有影响,表现为广泛IQ下降,语言智商影响较大,多数有行为问题。

Objective To investigate the neuropsychological impairment of children with electrical status epilepticus during sleep （ESES）. Methods Clinical observation and analysis were carried out in 30 cases with ESES from Jan. 2000 to Jul. 2006 in maternal and children＇s health hospital of Tangshan, 30 age and sex - matched epilepsy children with infrequent seizures and without ESES were collected as control group. The data were analyzed with SPSS 11.5 software. The result were expressed as x ± s, the compare of two sample means were used by t - test. They were progressed intelligence tests with wechsler intelligence scale for children - revised（ WISC - R）. The psychological and behavior abnormalities of children with ESES were analyzed and the neuropsychological impairment of children with ESES was evaluated. Results There were significant differences on verbal intelligence quotient （VIQ） between ESES group and control group. There were significant diffe-rences on performance intelligence quotient （PIQ） except for picture completion between ESES groups and control group. There were significant differences on full - scale intelligence quotient （FIQ） between ESES group and control group （ t = - 8. 732, - 8. 637, - 9. 129 Pa 〈 0.05 ）. Twenty - five of 30 （83.3%） patients had psychological and behavior abnormalities of children with ESES. Eleven cases （36.7%） developed language disorder, 7 cases（23.3% ） had learning problems,4（ 13.3% ）cases had aggressive,3 cases（ 10% ） had neurobehavioral disturbances with reduced attention span. Conclusions ESES has effect on intelligence to children. With a drop to IQ generally, especially to language intelligence, most have behavior abnormalities.