CAJ | 학술논문

目的探讨伴Rolandic区放电癫痫患儿的长程视频脑电图(VEEG)及临床特征.方法选择自2009年10月至2013年6月在厦门大学附属中山医院癫痫门诊就诊的伴Rolandic区放电的27例患儿,回顾性分析其临床资料、VEEG结果、影像学、治疗及预后. 结果 27例伴Rolandic区放电的患儿中,19例为伴中央颞区棘波的儿童良性癫痫(BECT),其中4例发作较少,未用药;其余15例单用奥卡西平,随访预后均良好;BECT变异型2例,多药联合激素疗效好;症状性癫痫3例(自闭症1例、脑炎后1例、局部皮质发育不良1例),多药联合治疗,第1例预后良好,第2例欠佳,第3例治疗无效后手术;儿童良性枕叶癫痫2例及多发性抽动症1例.影像学共6例异常,其中典型BECT3例,症状性癫痫3例.所有患儿VEEG特征均伴Rolandic区棘波、棘慢波发放,入睡后放电增多,个别泛化至全导或呈睡眠期癫痫性电持续状态. 结论 Rolandic区放电最常见于BECT,其次是症状性癫痫和BECT变异型,还见于儿童良性枕叶癫痫甚至无癫痫发作的患儿;VEEG系列检查可帮助鉴别诊断、判断预后和指导治疗.
목적 탐토반Rolandic구방전전간환인적장정시빈뇌전도(VEEG)급림상특정.방법 선택자2009년10월지2013년6월재하문대학부속중산의원전간문진취진적반Rolandic구방전적27례환인,회고성분석기림상자료、VEEG결과、영상학、치료급예후. 결과 27례반Rolandic구방전적환인중,19례위반중앙섭구극파적인동량성전간(BECT),기중4례발작교소,미용약;기여15례단용오잡서평,수방예후균량호;BECT변이형2례,다약연합격소료효호;증상성전간3례(자폐증1례、뇌염후1례、국부피질발육불량1례),다약연합치료,제1례예후량호,제2례흠가,제3례치료무효후수술;인동량성침협전간2례급다발성추동증1례.영상학공6례이상,기중전형BECT3례,증상성전간3례.소유환인VEEG특정균반Rolandic구극파、극만파발방,입수후방전증다,개별범화지전도혹정수면기전간성전지속상태. 결론 Rolandic구방전최상견우BECT,기차시증상성전간화BECT변이형,환견우인동량성침협전간심지무전간발작적환인;VEEG계렬검사가방조감별진단、판단예후화지도치료.
Objective To study and analyze the long-term video electroencephalography (VEEG) and clinical characteristics of children with Rolandic discharge.Methods Twenty-seven children with Rolandic discharge,admitted to our hospital from October 2009 to June 2013,were chosen in our study; theit clinical characteristics,VEEG results,imaging results,treatments and prognosis were retrospectively analyzed.Results In these 27 patients,19 had benign epilepsy with centrotemporal spikes (BECT),low-dose antiepileptic drug oxcarbazepine could obtain good efficacy in 15 patients and the other 4 did not give drug because of few seizures,and generally the prognosis was good; 2 had variants of BECT (therapy of antiepileptic drugs and corticosteroids had efficacy); 3 had symptomatic epilepsy (one was infantile autism,the other was encephalitis sequela,the last one was focal cortical dysplasia; therapy of antiepileptic drugs was combined,the result of the first one was good,the second one was not good,and the third was cured by surgery); and one had benign childhood occipital epilepsy and two had Tourette's syndrome.The VEEG of all 27 children showed numerous or single spikes on one side or both sides in Rolandic areas during wake-up and sleep; a few of them presented electrical status epilepticus during slow wave sleep.Conclusions Rolandic discharges in children are mostly seen in BECT,and secondly in symptomatic epilepsy and the variants of BECT,and sometimes in childhood occipital epilepsy and non-epilepsy children.VEEG monitoring can help the diagnosis and estimate the prognosis and instruct the therapy.