伴中央颞区棘波的儿童良性癫痫典型及非典型病例探讨

Benign epilepsy of childhood with centrotemporal spikes: study on typical and atypical cases

目的 探讨 BECCT典型与非典型特征 ,以提高对该病的认识。方法 分析 5 6例 BECCT临床发作形式、EEG表现、影像学及治疗资料。结果 5 6例中典型者 2 3例 (4 1.0 7% ) ;不典型病例 33例 (5 8.93% ) ,其中临床发作形式不典型 16例 (2 8.5 7% ) ,EEG不典型 2 5例 (4 4.6 4% )。头 CT及 MRI检查正常 46例 ,轻度异常 10例。卡马西平及丙戊酸对治疗典型和非典型的 BECCT均有效 ,以卡马西平为优。结论 BECCT的诊断应建立在对发病年龄、发作时间及形式、发作间期 EEG综合分析基础上 ,可以有不典型的发作。曾接受 AEDs治疗者 EEG可能不典型。

Objective To explore the typical and atypical characteristic of benign epilepsy of childhood with centrotemporal spikes (BECCT) to improve recongnition. Methods The data of clinical and EEG features, head CT and MRI, results of AEDs treatment in 56 cases of children with BECCT were analysed. Results In 56 cases, we found typical BECCT in 41.07%(23 cases), atypical cases in 58.93%(33 cases). In atypical BECCT, atypical clinical features in 28.57%(16 cases), atypical EEG features in 44.64%(25 cases). Head CT and MRI were performed, 46 cases were normal, 10 cases were slightly abnormal. Carbamazepine and valproate were often effective for control typical and atypical BECT, the former was more available. Conclusions The diagnosis of BECT should be based on comprehensive analysis of onset age, the time of seizure, the type of seizure and intermission EEG features, while there may be atypical type of seizure or EEG. EEG may be atypical in some children administered AEDs.