伴中央颞区棘波的儿童良性癫痫的临床特征及认知损害分析

doi:10.3969/j.issn.1006-6233.2022.05.022

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Abstract Objective: To study the clinical characteristics,EEG features and cognitive impairment of benign epilepsy in children with central temporal spikes (BECT) . Method: A total of 105 newly diagnosed BECT children were selected as the experimental group, and 105 healthy children were matched as the control group. The clinical course, MRI data and EEG were collected and analyzed in BECT group. Cognitive function was assessed between the two groups using the Wechsler Intelligence Scale for Children--4th edition (WISC-IV). Result: BECT mostly attacked shortly after falling asleep or just before waking up. In this study, 45 BECT children presented with focal seizure (originating from the oropharynx) and the other 60 with secondary generalized tonic-clonic seizure(GTCS). And EEG showed bilateral discharge in 65 patients and unilateral discharge in 40 patients. Among 105 patients ,7 had mild abnormality in MRI and 20 had positive family history of epilepsy or febrile convulsion. The full-scale IQ (FSIQ) and verbal comprehension index (VCI), perceptual reasoning index(PRI), working memory index(WMI), and processing speed index (PSI) were significantly reduced in the BECT group (P<0.001) compared with the control group. In the BECT group, the FSIQ,VCI, WMI and PSI of patients with bilateral discharge was significantly lower than that with unilateral discharge (P=0.024, P<0.001,P=0.004,P=0.011), while there was no significant difference in PRI between the two groups (P>0.05). In terms of seizure form, seizure frequency and seizure duration respectively, the VCI of children with secondary GTCS was significantly lower than that of children with focal seizure (P=0.031); the VCI of children with high seizure frequency was significantly lower than that of children with low seizure frequency (P<0.001); the WMI of the children with long duration of attack was significantly lower than that of the children with short duration of attack (P=0.006); but there was no corresponding significant difference in FISQ and other indexes(all P>0.05). Conclusion: Children with BECT have characteristic clinical features and a lower full-scale IQ than normal children, whose verbal comprehension, perceptual reasoning, working memory and processing speed were impaired. Bilateral discharge in EEG may be a risk factor for cognitive impairment. The form, frequency and duration of seizures also affect cognitive impairment in different degrees.

Key words： BECT Clinical characteristics Cognitive impairment

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2022.05.022 OR http://www.hbyxzzs.cn/EN/Y2022/V28/I5/803

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