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目的探讨儿童良性癫痫伴中央颞区棘波(BECT)的不典型临床表现、脑电图特点、治疗及预后。方法收集2006年12月至2012年7月在齐鲁医院就诊的122例BECT患儿的临床资料,对病程中出现不典型症状的11例BECT患儿进行动态脑电图或视频脑电图监测,并对其发作时的表现、神经心理学损伤及对抗癫痫药物治疗的反应进行分析和随访。结果 11例患儿病程中均出现发作形式的改变或脑电图恶化。2例丙戊酸钠治疗有效,4例丙戊酸钠加氯硝西泮治疗有效,3例托吡酯治疗有效。2例经多种抗癫痫药物治疗后,仍存在睡眠期脑电图癫痫性电持续状态。结论 BECT存在不典型表现,病程中可出现不同的发作形式,同时伴有脑电图的恶化及认知行为等方面的缺陷,发作相对难以控制。
Objective To investigate the atypical clinical manifestations, EEG characteristics, treatment and prognosis of benign epilepsy with central temporal spikes (BECT) in children. Methods The clinical data of 122 BECT patients who were treated in Qilu Hospital from December 2006 to July 2012 were collected. Eleven BECT patients with atypical symptoms in the course of their disease were monitored by dynamic EEG or video EEG. And the performance of the attack, neuropsychological damage and response to antiepileptic drugs were analyzed and followed up. Results All the 11 cases showed changes of seizure or deterioration of EEG during the course of their disease. 2 cases of valproate treatment is effective, 4 cases of sodium valproate plus clonazepam effective treatment, 3 cases of topiramate effective. 2 cases after a variety of anti-epileptic drugs, there is still sleep during the electroencephalogram epileptic seizure state. Conclusions There is an atypical manifestation of BECT. Different seizures may occur during the course of the disease, accompanied by defects in EEG deterioration and cognitive behavior. The seizures are relatively difficult to control.