伴中央颞区棘波的儿童癫痫预后分析

Prognostic analysis of children epilepsy with centrotemporal spikes

目的：探讨中央颞区（Rolando区）棘波的儿童癫痫的诊断和预后分析。方法：选择2010年7月~2015年7月具有特征性中央颞区放电并初诊为儿童良性癫痫（BEcT）的患儿82例，随访并分析其病情演变及预后。结果：82例中符合典型BECT者67例，预后良好，单药治疗后发作控制良好；未出现认知及精神运动方面的伴发症状；BECT变异型4例，脑电圈见癫痫性电持续状态（ESES）现象，药物控制效果不佳，随病程进展出现不同程度的认知损伤；11例在病程中出现多种发作类型，联合应用2～3种抗癫痫药物治疗。其中8例在病程2-4年时出现影像学变化，修正诊断为局灶性癫痫或继发性癫痫。螬论：Rolando区放电在儿童癫痫的诊断和预后的分析中，有重要参考价值。掌握Rolando区放电的图形识别、背景分析有助于提高儿童癫痫诊断的准确率，对预判病情的进展有一定作用。

Objective： To analyze the prognosis of children epilepsy with centrotemporal spikes. Methods：82 cases of epileptic children with centrotemporal spikes were selected. The EEG features, sei- zure semiology and responses to antiepileptic drugs were analyzed. Results：Out of 82 cases, 67 were con- firmed to be typical children benign epilepsy with centro-temporal spikes （BECT） with a good prognosis; 4 cases were variant BECT, with electrical status epilepticus in sleep （ESES） and cognitive decline in EEG; More seizure types and atypical symptoms were found in the other 11 cases, treated with two or more combined antiepileptic drugs . Conclusion：The analysis of centrotemporal spikes would improve the accuracy in diagnosis of children epilepsy and is helpful for the determination of the progress of BECT.