左乙拉西坦对儿童良性癫(癎)伴中央颞区棘波伴睡眠中癫(癎)性电持续状态疗效观察

摘要

Objective To investigate the effect of levetiracetam on benign childhood epilepsy with centro-temporal spikes(BECT) with early-electrical status epilepticus during sleep(ESES).Methods Since June 2010 to June 2013,35 cases of BECT with ESES were treated in our hospital.They were divided into two groups:early-ESES group and ESES group.The seizure rate and spike-wave index in different groups were observed before and after treatment.Intelligence quotient(IQ),response control quotient,attention quotient in different groups were compared before and after treatment.Results The seizure-free rate in earlyESES group was 55.00％,the total effective rate was 85.00％,EEG improvement rate was 60.00％.The seizure-free rate in ESES group was 26.67％,the total effective rate was 73.33％,EEG improvement rate was 46.67％.The seizure-free rate,total effective rate and EEG improvement rate in early-ESES group were higher than that in ESES group,but there were no statistically significant differences between two groups.The cognitive function (verbal IQ:90.29 ± 13.47 vs.83.97 ± 10.20; performance IQ:93.83 ± 11.12 vs.87.03 ± 11.15; full IQ:94.26 ± 10.96 vs.86.71 ± 11.29) and visual attention in both groups (response control quotient:100.77 ± 7.91 vs.87.40 ± 9.68 ; attention quotient:94.66 ± 7.22 vs.79.46 ± 12.52) were significantly improved after treatment(P ＜ 0.05,respectively).Conclusion Levetiracetarn is effective on BECT with ESES and early-ESES,especially on early-ESES.Levetiracetam maybe have a preventive effect on ESES.%目的 探讨左乙拉西坦对儿童良性癫(癎)伴中央颞区棘波(benign childhood epilepsy with centro-temporal spikes,BECT)伴睡眠中癫(癎)性电持续状态(electrical status epilepticus during sleep, ESES)的疗效.方法 将2010年6月至2013年6月在我院癫(癎)门诊和住院就诊的35例BECT伴ESES患儿分为两组:ESES前期组和ESES组,分别用抗癫(癎)药左乙拉西坦治疗,观察左乙拉西坦对ESES前期和ESES患儿的癫(癎)发作频率、放电指数及神经心理的影响,通过比较治疗前后和不同时期疗效,探讨左乙拉西坦对ESES的预防作用和治疗作用.结果 ESES前期组患儿的临床控制率为55.00％,总有效率为85.00％,脑电图改善率60.00％;ESES组患儿的临床控制率为26.67％,总有效率为73.33％,脑电图改善率46.67％,但两组比较差异无统计学意义.左乙拉西坦治疗后患儿认知功能(语言智商:90.29±13.47;操作智商:93.83 ±11.12;总智商:94.26±10.96)和视觉注意力(反应控制商:100.77±7.91;注意商:94.66±7.22)较治疗前(语言智商:83.97±10.20;操作智商:87.03±11.15;总智商:86.71 ±11.29;反应控制商:87.40±9.68;注意商:79.46±12.52)明显改善,差异均有统计学意义(P均＜0.05).结论 左乙拉西坦可作为治疗BECT伴ESES和ESES前期的抗癫(癎)药物,且ESES前期治疗效果更佳,对ESES有一定预防作用.