儿童睡眠中癫癎性电持续状态的临床与脑电图特点

目的总结儿童睡眠中癫痫性电持续状态(ESES)的临床、脑电图特点及治疗反应。方法应用AEEG或VEEG 监测,对26例ESES患儿临床、脑电图、神经心理损伤及治疗进行随访观察。结果25例有癫痫发作。21例病前智力运动发育正常。病后16例精神行为异常,15例语言障碍,13例两者兼有。17例归于癫痫综合征。氯硝西泮、丙戊酸钠治疗反应良好,激素对于消除电持续状态效果明显。随访18例,15例发作控制。16例ESES消失后4例仍留有神经心理损伤。2例ESES 仍存在。结论ESES是一种特殊脑电图现象,非快动眼(NREM)睡眠期持续放电是神经心理损伤主要原因,有效控制癫痫发作,消除电持续状态,是改善神经心理损伤的关键。

Clinical and Electroencephalogram Characteristics of Children with Electrical Status Epilepticus during Sleep

Objective To investigate the clinical and electroencephalogram (EEG) characteristics of children with electrical status cpilepticus during sleep (ESES), and the response to medication therapy. Methods AEEG and VEEG including an entire sleeping c-ycle were performed on 26 patients with ESES. The clinical and EEG changes, neuropsychological impairment and the response to medication therapy were followed up. Results Twenty five patients had seizures,21 cases had normal psychomotor development before ESES. After the onset of the disease,Fifteen cases developed language disorder, 16 cases developed psychological and behavior abnormalities, 13 cases had both of the problems Seventeen patients belonged to epileptic syndrome. Patients in this cohort had good response to clonazepam and valproate treatment. Cortical steroid could dispel the electrical discharge. Eighteen patients had been followed up. Seizures stopped in 15 cases after treatment ESES disappeared in 16 cases, 4 of them still had neuropsychological impairment ESES sustained in 2 cases Conclusions ESES is a specific EEG phenomenon. Continue epileptic form discharge during non - rapid cye movement sleep is the major cause of neuropsychological impairment in patients with ESES. To control the seizures and electrical state are very important for the prevention and treatment of neuropsychological impairment.