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目的回顾性分析儿童良性癫痫伴中央颞区棘波(BECT)的临床特征及脑电图特点。方法收集自2008年2月到2011年12月,本院神经内科住院及门诊共收治的符合BECT诊断标准并完成6个月至3年随访的56例患儿,总结其临床资料、脑电图、及治疗随访资料。结果 56例BECT患儿中,男34例,女22例;发病年龄2岁1个月～11岁6个月,中位年龄7.5岁。发作类型为部分运动性发作41例,部分继发全身性23例及两种发作类型均有8例。发作主要表现为面部抽动、流涎、喉咙出声、言语不能、眼睛斜视、眼睑眨动、肢体抽动等,发作与睡眠密切相关。发作间期脑电图背景活动正常,痫样放电在睡眠期均出现,且多在NREM期。放电部位多位于中央或中颞区,复查脑电图其异常局灶放电可在一侧或两侧半球内的中央和中颞之间移动;可暂时性消失。3例BECT变异型脑电图特点为清醒期及睡眠期中央、中颞区极高电压的棘或棘慢波频繁发放;NREM睡眠期放电指数≥50%。结论 BECT临床发作与睡眠有密切相关,脑电图检查可见限局性棘波或尖波,多位于中央区或中颞区,多数预后良好,但也有部分患者预后不良。
Objective To retrospectively analyze the clinical features and EEG features of benign epilepsy with central temporal spikes (BECT) in children. Methods From February 2008 to December 2011, 56 children with in-hospital and outpatient cohorts who met BECT diagnostic criteria and were followed up for 6 months to 3 years were enrolled in this study. The clinical data, EEG , And treatment follow-up information. Results 56 cases of BECT children, 34 males and 22 females; onset age 2 months 1 months to 11 years 6 months, the median age 7.5 years. The types of seizures were 41 with partial motor attacks, 23 with partial secondary systemic diseases and 8 with both seizure types. Attack mainly manifested as facial twitch, salivation, throat sound, speech can not, strabismus, eyelid blink, limb twitch, seizures and sleep are closely related. Intermittent EEG background activity is normal, epileptiform discharges appear during sleep, and more in the NREM period. Discharge location and more in the central or middle temporal area, review EEG abnormal discharge can be in one or both sides of the hemisphere within the center and the middle of the temporal shift; may temporarily disappear. 3 cases of BECT variant EEG characteristics of the awake and sleep during the central and middle temporal very high voltage spines or spikes and waves slow release; NREM sleep discharge index ≥ 50%. Conclusions The clinical seizure of BECT is closely related to sleep. Electroencephalography shows limited spikes or spikes, mostly in the central or middle temporal region. Most of the patients have a good prognosis, but some patients have poor prognosis.