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目的探讨伴中央-颞区棘波的儿童良性癫(BECTS)的临床和脑电图(EEG)特征。方法对2003年7月-2008年12月在本院癫门诊就诊的35例BECTS患儿的临床资料、EEG结果、药物治疗反应及预后进行回顾性分析。结果本组35例BECTS患儿的起病年龄为2.5～14.0岁,其中6～10岁为发病高峰(62.9%)。表现为局限性发作22例:一侧面部抽搐、流涎、咽喉发声、肢体强直或阵挛,部分继发全面性强直阵挛发作。仅表现为全面强直阵挛发作者13例。发作与睡眠密切相关,26例仅在睡眠期(包括午睡)发作,且多出现于入睡后不久或清醒前。所有患儿发作间期EEG背景活动正常,可见一侧或双侧中央-颞区尖波/棘波,发放频度于入睡后明显增加,睡眠期EEG监测可提高阳性率。应用小剂量抗癫药物单药治疗疗效好,25例在用药3～4个月停止发作,本组33例已停止发作,停止发作的年龄为4.5～16.0岁,12例已停止药物治疗。结论BECTS多发生于学龄期儿童,表现为局限性发作,也可全面泛化,发作与睡眠密切相关,睡眠期EEG监测具有重要诊断价值,EEG表现为一侧或双侧中央-颞区尖波/棘波,小剂量抗癫药物单药治疗反应良好,预后一般良好。
Objective To investigate the clinical and electroencephalographic (EEG) features of benign epilepsy (BECTS) in children with central-temporal spikes. Methods The clinical data, EEG results, drug treatment response and prognosis of 35 BECTS children with epilepsy in our hospital from July 2003 to December 2008 were analyzed retrospectively. Results The onset age of 35 children with BECTS ranged from 2.5 to 14.0 years, of which 6 to 10 years was the peak (62.9%). The performance of the limitations of episodes in 22 cases: one side of the face convulsions, salivation, throat sound, limb rigidity or clonus, and some secondary to comprehensive tonic clonic seizures. Thirteen patients showed only complete tonic clonic. Seizures and sleep are closely related, 26 cases only during sleep (including nap) episodes, and more often appear in shortly after sleep or before awake. All children with interictal EEG background activity was normal, showing one or both of the central - temporal spikes / spikes, release frequency significantly increased after falling asleep, sleep EEG monitoring can increase the positive rate. Application of low-dose anti-epilepsy drug monotherapy efficacy, 25 cases of medication in 3 to 4 months to stop the attack, the group of 33 patients had stopped attacking, the onset of seizure was 4.5 to 16.0 years old, 12 patients have stopped drug treatment. Conclusions BECTS mostly occurs in school-age children, showing localized attack or generalization. The onset of seizures is closely related to sleep. EEG monitoring during sleep has important diagnostic value. EEG manifests as one or both central-temporal spikes / Spike, low-dose anti-epileptic drug monotherapy response, the prognosis is generally good.