Follow-up study of normal children with centro-temporal spikes
伴有中央颞区放电儿童的随访研究

摘要

目的 通过随访伴有中央颞区放电的儿童的自然病程，观察其有无癫痫发作，探讨BECTS与临床下癫痫样放电的关系，对临床治疗给予指导。方法 随访观察5例伴有中央颞区放电但无癫痫发作儿童的临床表现、VEEG和影像学资料。随访时间3~5年。结果 4例儿童中男3例，女2例；入组年龄4~9岁；既往史无特殊；有1例儿童的兄长有癫痫发作史，余无家族史。就诊原因分别为头痛、头晕、多动症、有家族史而自行检查。所有儿童神经系统查体和头MRI检查均正常。随访过程中一直未见发作。随访前VEEG检查显示睡眠期一侧或双侧中央和颞区高波幅尖波或棘波发放，清醒期正常；随访末VEEG恢复正常。结论 伴中央颞区放电的儿童良性癫痫 (BECTS)是一种特殊类型的临床-电生理癫痫，其临床发作及脑电图表现具有年龄相关的特征性，预后良好。部分不典型BECTS患儿可能疗效不佳，但对于无发作的伴有BECTS癫痫样放电的儿童不必早期给予抗癫痫药物治疗。

Abstract

Objective To investigate the relationship between BECTS and clinical epileptic discharge and to provide guidance for clinical treatment by following up the natural course of disease of children with centro-temporal spikes.
Methods Clinical manifestations, VEEG and imaging data of 5 children who had no epileptic seizure with centro-temporal spikes were observed. Follow-up time was from 3 to 5 years.
Results There were 3 males and 2 females. Enrolment age was between 4 and 9 years old. All past history were nothing special. The elder brother of one child had a history of epilepsy, and the rest had no family history. The reasons for the treatment were respectively headache, dizziness, hyperactivity of the head and self-examination for positive family history.All head MRI and physical examination of nervous system were normal. No attacks were observed during the follow-up. Early VEEG examination showed that the high amplitude sharp wave or spike wave occurred in the lateral or bilateral central and temporal regions during NREM sleep, but VEEG during the awake period was normal. VEEG returned to normal at the end of follow-up.
Conclusion  s BECTS is a special type of clinical-electrophysiological epilepsy whose prognosis is good. The clinical and electroencephalogram features are age-related. Some children with atypical BECTS may have poor efficacy, but for children without seizures accompanied by typical epileptic discharge as BECTS, it is not necessary to give early antiepileptic medication.