伴中央颞区棘波的儿童良性癫(痫)治疗前后脑电图与认知功能的对比分析

摘要

Objective To study the EEG discharge index, intelligence test and event-related potential P300 in BECT, and to analyze the change of EEG discharge index and cognitive function before and after the treatment.Methods Sixty patients with BECT were enrolled in this study, they were treated with EEG, intelligence tests and P300 before and after the treatment.Results (1) The EEG discharge index were reduced remarkly after treatment in BECT with levetiracetam and lamotrigine, the difference was statistically significant (P ＜ 0.05).(2) Comparing before and after 3 or 6 months treatment, the latency of P300 had reduced with significant difference (P ＜ 0.05).(3) After 3 months treatment, VIQ and FIQ has no obvious improvement, but PIQ has improved.After 6 months treatment, VIQ、 PIQ and FIQ were improved.The difference was statistically significant (P ＜ 0.05).(4) There was a negative correlation of EEG P300 latency (r =0.175), as well as there was a negative correlation between EEG discharge index and intelligence test (r =0.044).Conclusion There is impaired cognitive function in BECT, especially the more frequently the EEG discharge, the more extended of P300 latency, as well as the more serious damage of intelligence and cognition after treatment.The intelligence were improved after treatment with Levetiracetam and lamotrigine, the longer the treatment time, the more obvious of intelligence levels improve.%目的 通过研究伴中央颞区棘波的儿童良性癫(痫)(benign childhood epilepsy with centro-tem-poral spikes,BECT)患儿的脑电图放电指数、智力测试得分及事件相关电位P300潜伏期,分析治疗前后脑电图放电指数与认知功能的改变.方法 选取60例BECT患儿,治疗前后均监测视频脑电图、智力测试及P300,并比较三者结果之间的差异.结果 (1)BECT患儿通过左乙拉西坦、拉莫三嗪治疗后VEEG放电较治疗前明显减少,差异具有统计学意义(P＜0.05).(2)治疗3个月、6个月P300潜伏期与治疗前比较,差异具有统计学意义(P＜0.05).(3)治疗3个月言语智商、总智商无明显改善,而操作智商提高,言语智商与总智商差异无统计学意义(均P＞0.05),治疗6个月所有患儿的言语智商、操作智商及总智商均升高,差异具有统计学意义(均P ＜0.05).(4)脑电图放电指数与P300相关性分析结果(r=0.175),与智力测试的相关性分析结果(r =0.044),呈负相关.结论 BECT患儿均存在智力受损,脑电图放电越频繁,P300潜伏期延长,智力受损害越严重.左乙拉西坦、拉莫三嗪治疗后智力均有所改善,治疗时间越长,智力改善越明显.