典型与非典型伴有中央颞区棘波的儿童良性癫痫对比研究

摘要

目的 比较典型与非典型伴有中央颞区棘波的儿童良性癫痫(BCECTS)的临床特征与治疗效果.方法 回顾性纳入30例典型BCECTS患者(典型组)和18例非典型BCECTS患者(非典型组),比较两组患者性别、发病年龄、癫痫发作形式、癫痫发作频率、神经影像学、脑电图表现和智商分值、接受抗癫痫药物治疗的比例和无发作＞48周的患者比例.结果 48例BCECTS患者男女比为1.8∶1,两组患者性别构成差异无统计学意义(x2＝0.055,P＞0.05)；非典型组发病年龄[(6.5±1.6)岁]较典型组发病年龄[(7.8±1.2)岁]早(t=3.20,P＜0.05)；治疗前癫痫发作频率典型组[(2.0±1.0)次/月]与非典型组[(2.1±1.1)次/月]比较差异无统计学意义(t=-0.32,P＞0.05)；言语智商典型组(105.6±8.1)与非典型组(100.1±12.9)比较差异有统计学意义(t=2.05,P＜0.05)；头颅影像学异常比例非典型组(10例,58.8％)较典型组(2例,8.0％)明显(x2=12.8,P＜0.05)；EEG示其他脑区异常放电非典型组(6例,33.3％)较典型组(5例,16.7％)明显(x2=4.4,P＜0.05).非典型组(17例,97.4％)较典型组(24例,80.0％)更易于接受抗癫痫药物治疗(x2=12.8,P＞0.05).无发作＞48周的患者比例典型组(14例,70.0％)高于非典型组(5例,33.3％)(x2=4.64,P＜0.05).结论 非典型BCECTS在发病年龄、智力、脑电图和神经影像学和治疗效果上与典型BCECTS差异有统计学意义,早期鉴别BCECTS的类型有助于选择治疗方案和判断预后.%Objective To compare the clinical features and treatment of typical and atypical benign childhood epilepsy with centrotemporal spikes (BCECTS). Methods Thirty patients of typical BCECTS (the typical group) and 18 patients of atypical BCECTS (the atypical group) were compared in terms of gender, age of onset of seizures, frequency of seizures, neurological imaging data, EEG performances, IQ scores and the proportion to receive antiepileptic drugs and that with seizures free more than 48 weeks. Results Of the 48 patients, the male to female ratio was 1.8:1, and there was no statistically significant difference in gender between the two groups (x2=0.055, P>0.05). The age of onset of seizure in the atypical group [(6.5±1.6) years] was significantly earlier than that in the typical group [(7.8±1.2) years], t=3.20, P<0.05. The frequency of seizures before treatment had no statistically significant difference (t=-0.32, P>0.05) between the typical group [(2.0±1.0) per month] and the atypical group [(2.1±1.1) per month]. The scores of verbal IQ of the typical group [(105.6±8.1)] were significantly higher than that of the atypical group [(100.1±12.9)], f=2.05, P<0.05. The proportion of neurological imaging abnormalities of the atypical group (10 cases, 58.8%) was significantly larger than that of the typical group (2 cases, 8.0%), x2=12.8, P<0.05. The proportion of abnormal discharge in other brain regions in the atypical group (6 cases, 33.3%) was significantly larger than that in the typical group (5 cases, 16.7%), x2=4.4, F<0.05. The atypical group (17 cases, 97.4%) was more acceptable to the antiepileptic drugs than he typical group (24 cases, 80.0%), x2=12.8, P>0.05). The proportion of seizure free more than 48 weeks in the typical group (14 cases, 70.0%) was significantly larger than that in the atypical group (5 cases, 33.3%), x2=4.64, P<0.05. Conclusion There are statistically significantly differences in age of onset of seizures, intellectual quotient, EEG per- formances, neurological imaging and treatment efficacy between typical and atypical BCECTS. It would be helpful for the selection of treatment strategy and the prognosis to identify the typical and atypical BCECTS.