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目的探讨儿童良性癫伴中央颞区棘波(BECT)的临床表现和脑电图变化的特点。方法对2002-07—2004-09在北京儿童医院神经科门诊治疗的59例BECT患儿的临床资料进行分析,诊断明确后予抗癫药物治疗,其中28例患儿于治疗后3、6个月复查脑电图,比较治疗前与治疗后脑电图异常放电部位、放电频度及波形的动态变化。结果发病高峰年龄为7~9岁,癫发作类型为部分运动性发作(27/59例)、部分泛化全身性发作(48/59例)及两种发作类型均有(16/59例)。发作与睡眠密切相关,多在刚入睡不久(46/59例)或晨起欲醒时(25/59例)。临床主要表现为一侧口角歪斜或抽动(54.2%)、流涎(40.7%)和言语不能(27.1%),夜间易泛化为全身性发作。发作间期脑电图背景活动正常,在中央和(或)中颞区可见高幅棘波或尖波。治疗前与治疗后多数(21/28例)脑电图异常放电是变化的,或在中央和中颞区间移动,或由一侧转到另一侧,治疗3个月时7例(7/28)例异常放电消失,治疗6个月时其中5/7例异常放电又出现。2例监测到临床发作,脑电图为起源于发作对侧中央中颞的节律性低幅棘波、尖波,逐渐波及同侧甚至对侧导联。结论BECT具有与睡眠密切相关的两种发作类型,以部分泛化全身性发作居多(48/59例)。脑电图特征对该病诊断有重要价值,中央中颞区棘波具有变化性、游走性甚至一过性消失的特点。
Objective To investigate the clinical features and EEG changes of benign epilepsy with central temporal spine (BECT) in children. Methods The clinical data of 59 BECT children who were treated in Department of Neurology of Children’s Hospital of Beijing from July 2002 to September 2004 were analyzed and treated with anti-epileptic drugs after diagnosis. Among them, 28 cases were treated with 3,6 Month EEG examination, comparison before and after treatment of abnormal discharge parts of the EEG, discharge frequency and waveform of dynamic changes. Results The peak age of onset was 7-9 years. The types of seizures were partial motor attacks (27/59 cases), partial generalized sepsis (48/59 cases) and both seizure types (16/59 cases ). Seizures and sleep are closely related, mostly just fell asleep soon (46/59 cases) or morning wake up (25/59 cases). The main clinical manifestations of skew or twitch side of the mouth (54.2%), salivation (40.7%) and speech can not (27.1%), the generalization of the generalization of the generalized at night. Intermittent electroencephalogram background activity normal, in the central and (or) in the temporal area can be seen spikes or spikes of high amplitude. Before and after treatment, the majority (21/28 cases) of abnormal EEG discharges were changed, or in the central and mid-temporal shift, or from one side to the other side, the treatment of 3 months, 7 cases (7 / 28) cases of abnormal discharge disappeared, treatment of 6 months when 5/7 cases of abnormal discharge reappeared. 2 cases of clinical seizures were detected, EEG originated in the contralateral central mid-temporoparietal low-amplitude spikes, sharp waves, and gradually spread to the ipsilateral side of the lead or even. Conclusions BECT has two types of seizure closely related to sleep, with partial generalized generalized seizures (48/59 cases). EEG features of the diagnosis of the disease has an important value in the central spino-temporal variability, wandering or even a transient disappearance of features.