75例儿童良性癫痫伴中央颞区棘波患儿的临床特征和脑电图分析

目的 分析儿童良性癫痫伴中央颞区棘波(BECT)的临床特征和脑电图特点.方法 收集2011年1月至2015年4月符合BECT诊断标准并完成6个月～4年随访的75例患儿的临床资料,男42例,女33例,发病年龄3 ～13岁,中位年龄7.5岁,总结其临床特点、分析脑电图及治疗随访结果.结果 75例BECT患儿中,发作类型为部分运动性发作33例,其中复杂部分性发作10例,部分继发全面性发作42例,两种发作类型均有2例.发作主要表现为言语不能、面部抽动、喉中呼噜声、流涎、双眼斜视、眼睑眨动,一侧或继发双侧肢体抽动或僵硬等.发作间期脑电图背景活动正常,癫痫样放电除l例外余均在睡眠期出现,且多见于快速动眼(NREM)期.放电部位位于中央或中颞区,复查脑电图异常局灶放电可在双侧半球的中央、中颞之间游走或在同侧半球的偏前头部或偏后头部之间游走;也可短暂消失.结论 BECT临床发作多发生于睡眠期,脑电图放电多位于中央或中颞区,多数预后良好,但也有少部分患儿预后不良.

Benign epilepsy of children with central temporal spikes-clinical and EEG analysis in 75 pediatric patients

Objective To retrospectively analyze the clinical and EEG features of benign epilepsy with central temporal spikes (BECT) in pediatric patients.Methods From January 2011 to 2015 in April,in the Pediatric Department of our hospital 75 inpatient and outpatient cases were treated with BECT based on diagnostic criteria and completed follow-up for 6 months to 4 years,there were 42 boys and 33 girls,with age raging from 3 years old to 13 years old and a median age of 7.5 years.The clinical data,EEG and follow-up data were summarized.Results In the 75 patients with BECT,33 cases had partial movement attack including complex partial seizure in 10 cases,42 cases had secondary comprehensive attack and 2 cases had both type of attacks.Attacks mainly appeared as unable to speak,facial tics,grunts,salivation,eyes squinted,eyelid blink movement in the throat,side or secondary bilateral limbs twitch or stiff etc.Attacks were closely related to sleep.The background EEG activity was normal at interval between the attacks.The epileptic discharges were all in the sleep phase except for 1 case,and were more common in the period of NREM.The discharge site was located in the central or middle temporal area,and the EEG abnormal focal discharge was loca ted in the central and middle temporal between the bilateral hemisphere,or between the front head of the same side or the back of the head.The discharge index of BECT variation type EEG was 70％ in 3 cases.Conclusion BECT is closely related to sleep.EEG discharge is located in the central or central temporal region.The prognosis is good in most of the patients although there are a small number of children with poor prognosis.