伴中央-颞区棘波的儿童良性癫痫临床与脑电图分析

Clinical and EEG analysis of benign chidhood epilepsy with centro-temporal spikes

目的探讨伴中央颞区棘波儿童良性癫痫(benign childhood epilepsy with centro-temporal spikes,BECT)的临床特点、脑电图(EEG)改变及预后情况。方法采用数字视频脑电图仪和动态脑电监测,对31例BECT患儿进行清醒和睡眠脑电图描记,结合临床表现及影像学资料进行随访分析。结果本组发病年龄为2.5岁-14岁,其中5-10岁发病24例(占77.42%),发作均与睡眠有关,2例发病后有语言障碍。发作间期EEG背景波正常,在一侧或双侧中央区和中颞区出现负性、双向或多向的棘波或尖波,或棘慢综合波,入睡后放电频率明显增加。影像学检查有1例侧脑室扩大,其余正常。结论BECT多见于5-10岁儿童,临床发作与睡眠密切相关,EEG有特征性改变,表现为一侧或双侧中央和/或中颞区有尖波、棘波或棘慢综合波发放。抗癫痫药物治疗有效,大部分预后良好,2例有认知功能障碍。

Objective The goal of this work was to discuss about clinical characteristics, electroencephalogram（EFE,） transformarion and prognosis of benign children epilepsy with centro-temporal spikes （BECT）. Methods Thirty one children with BECT were recorded awake and sleep electroencephalogram by using digital video electrocephalograph and dynamic electroencephalogram inspection, analyzing with combination of clinical manifestation and image. Results The group onset occured between the ages of 2.5 to 14 years. Among, 24 cases （77 .42% ） seizures was between age of 5 and 10. Onset was related with sleep.2 children presented language impairment after onset. Background waves of interical EEG was normal, and unilateral or bilateral centro-temporal showed negative, bidirectional or multidirectional spike or sharp wave, or spike-and-slow, which discharge frequency increased markedly during sleep. Only one image showed lateral ventricle enlarged, and others were all normal. Conclusion BECT usually occurs in children aged 5 - 10 years. Clinical seizure has affinirive relationship of sleep. ECG has characteristic transformation, which performs that unilateral or bilateral centro-temporal showed negative, bidirectional or multidirectional spike, sharp wave, or spike-and-slow. With the regular antiepileptic drug treatment, scizures can be controlled in most BECr patients, and prognosis is benign. 2 children presented cognitive problems after onset.