左乙拉西坦治疗儿童睡眠中癫痫性电持续状态临床研究

发布时间：2018-02-15 08:01

本文关键词： 睡眠中癫痫性电持续状态(ESES) 左乙拉西坦(LEV) 脑电图(EEG) 儿童　出处：《中国人民解放军军医进修学院》2012年硕士论文　论文类型：学位论文

【摘要】：目的儿童睡眠中癫痫性电持续状态(ESES)是一种特殊的脑电图现象,发生率占儿童癫痫的0.2%-0.5%,主要指非快动眼(NREM)睡眠期持续广泛棘慢波发放占整个NREM期的85%以上,伴或不伴癫痫发作。ESES不是一个独立的癫痫综合征,而是包括了一系列不同病因、不同临床表现及不同预后的多种癫痫综合征,目前尚无统一治疗方法。本课题通过总结分析27例ESES患儿对左乙拉西坦(levetiracetam,LEV)治疗的反应,探讨临床应用左乙拉西坦治疗儿童ESES的可行性。方法将本院2009年8月至2011年3月首诊的27例ESES患儿按照使用LEV治疗的时相分成A、B两组,对其临床发作控制情况及脑电图(electroencephalogram, EEG)改善情况随访至少6个月,分别观察其使用LEV治疗的效果,分析LEV治疗儿童ESES的疗效。结果27例ESES患儿,男17例,女10例,起病年龄9月～9岁7月,起病早期89%的患儿为局限性运动发作。A组23例为ESES确诊后加用LEV,其中19例归属于儿童良性癫痫伴中央颞区棘波(BECT),4例为非BECT的ESES。LEV开始治疗年龄为1岁8月～11岁9月,随访时间为7-19个月。LEV控制临床发作有效率为82%,改善脑电图(EEG)情况有效率为78%。LEV控制临床发作效果优于改善EEG效果(P=0.00080.05)。B组4例(15%)ESES患儿于ESES出现前已加用LEV,并未能阻止ESES的发生。结论LEV在控制临床发作和改善脑电图放电方面均有一定疗效,可用于临床ESES患儿的治疗。4例ESES患儿在ESES前已加用LEV,提示LEV的使用可能并不能阻止ESES的出现。
[Abstract]:Objective epileptic status epilepticus (ESE) is a special electroencephalogram (EEG) phenomenon in children. The incidence rate of EES is 0.2-0.5 in children with epilepsy, mainly refers to the non-rapid eye movement (NREM) sleep period, the duration of ESES is more than 85% of the whole NREM stage. ESEs with or without seizures is not an independent epilepsy syndrome, but includes a variety of epilepsy syndrome with different etiology, different clinical manifestations and different prognosis. At present, there is no unified treatment method. In order to explore the feasibility of clinical application of levoethiracetam in the treatment of children with ESES, we analyzed the response of 27 cases of children with ESES to levetiracetam Levo. Methods from August 2009 to March 2011, 27 patients with ESES were divided into two groups according to the time phase of LEV treatment. The clinical seizure control and EEG electroencephalograms (EGG) improvement were followed up for at least 6 months. To observe the effect of LEV and analyze the effect of LEV on children with ESES. Results there were 27 cases of ESES, 17 males and 10 females. The onset age was from September to July. In group A, 23 patients were diagnosed with ESES and treated with Levi, 19 of them belonged to benign epilepsy with BECT of central temporal region. The age of ESES.LEV was 1 year, August and 11 years old, and the age of ESES.LEV was 11 years, from August to September, the age of treatment was 1 year, August and 11 years, respectively. The follow-up time was 7-19 months. The effective rate of LEV to control clinical attack was 82. The effective rate of improving electroencephalogram (EEG) was 78.LEV was better than that of improving EEG. 4 patients in group B had been treated with Levus before ESES, and could not prevent the occurrence of ESES. Conclusion LEV is effective in controlling clinical attack and improving EEG discharge. It can be used in the treatment of 4 cases of ESES patients with ESES before ESES. It suggests that the use of LEV may not prevent the appearance of ESES.
【学位授予单位】：中国人民解放军军医进修学院
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R742.1

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