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目的探讨儿童良性癫痫伴中央颞区棘波(BECTS)变异型的儿童智商影响因素,为临床诊疗提供参考依据。方法回顾性分析2010年1月-2015年1月就诊于新疆维吾尔自治区人民医院儿科的15例BECTS变异型患儿的临床特征(临床发作特点、智力及神经心理损害情况、脑电图特点、药物治疗反应等),并对BECTS变异型患儿语言量表各项分值与临床各因素进行相关性分析,对脑电图单侧和双侧异常放电部位的智商进行t检验比较。结果66.7%的BECTS变异型患儿存在一定程度的学习障碍,15例视频脑电图均显示一侧或双侧中央、顶区和(或)中、后颞区(Rolandic区)散在的棘慢波或棘波发放,睡眠后明显增多,部分达到睡眠期癫痫性电持续状态(ESES)现象。语言量表各项分值与非快速眼动(NREM)期棘慢波指数(SWI)≥50%持续时间、变异症状持续的时间呈负相关,单侧脑区及双侧脑区存在异常频繁放电两组之间智商差异无统计学意义。结论 BECTS变异型患儿存在认知损害,变异症状持续时间越长、NREM期SWI≥50%持续时间越长,认知功能损害越重。甲基强的松龙冲击联合抗癫痫药物可对大部分BECTS变异型患儿临床改善有效,对BECTS变异型患儿认知损害及语言发育的变化追踪是一个长期的过程。
Objective To investigate the influencing factors of children’s intelligence in children with benign epilepsy and centrotemporal spikes (BECTS) variant, and provide a reference for clinical diagnosis and treatment. Methods The clinical features (clinical features, intelligence and neuropsychological impairment, characteristics of electroencephalogram, medication of 15 patients with BECTS variant) admitted to the Pediatrics Department of People’s Hospital of Xinjiang Uyghur Autonomous Region from January 2010 to January 2015 were retrospectively analyzed. Treatment response, etc.), and analyzed the scores of various scales and clinical factors in children with BECTS variant. The IQ of unilateral and bilateral abnormal discharges was compared by t-test. Results 66.7% of children with BECTS variant had some degree of learning disability. 15 cases of video EEG showed spines scattered in the central, apical and / or middle and posterior temporal regions (Rolandic region) Wave or spike wave release, significantly increased after sleep, part of the sleep to reach epileptic electrical continuity state (ESES) phenomenon. The scores of language scales were negatively correlated with duration of ≥50% duration of SWMI and duration of variation symptoms in non-REME, with abnormalities in unilateral and bilateral brain regions Discharge IQ between the two groups was not statistically significant. Conclusion There is cognitive impairment in children with BECTS variant. The longer the duration of variation symptoms, the longer duration of SWI≥50% in NREM, and the heavier cognitive impairment. Methylprednisolone combined with anti-epileptic drugs can improve clinical outcomes in most children with BECTS variant. It is a long-term process to track changes in cognitive impairment and language development in children with BECTS variant.