论文部分内容阅读
目的探讨左乙拉西坦(LEV)联合短程氯硝西泮(CZP)治疗儿童Rolandic癫癎(BECCT)睡眠中癫癎电持续状态(ESES)的效果。方法采用24 h便携式动态脑电(AEEG)或3 h视频脑电(VEEG)监测,以非快速动眼(NREM)睡眠期出现持续广泛性棘慢波发放占整个NREM期的85%以上作为ESES的诊断标准,回顾分析15例(男9例,女6例)诊断为ESES的BECCT患儿临床表现及脑电图特点。患儿在口服LEV[20~40 mg/(kg·d)]基础上联合2个月短程CZP,并随访6~18个月。结果 15例患儿早期给予LEV单药治疗过程中复查EEG无改善或同时有癫癎发作,继而给予联合治疗(LEV+短程CZP);治疗后第1、6个月复查,14例患儿EEG放电明显减少(仅Rolandic区少量放电)或消失,发作完全控制,1例随访过程中ESES复发并癫癎发作2次,重复上述联合治疗方案后第1、6个月复查,EEG正常范围,再次随访8个月无发作。结论 LEV联合短程CZP对BECCT患儿ESES的控制相对理想、副作用少。
Objective To investigate the effect of levetiracetam (LEV) combined with short-course clonazepam (CZP) on status epilepticus (ESES) in childhood Rolandic epilepsy (BECCT) sleep. Methods Continuous 24 h EEG or 3 h EEG monitoring was used to detect the persistent non-rapid eye movement (NREM) with more than 85% of the total NREM phase as ESES The clinical features and EEG features of 15 children with BECCT diagnosed as ESES were retrospectively analyzed in 15 cases (9 males and 6 females). Children with oral LEV [20 ~ 40 mg / (kg · d)] combined with 2-month short-range CZP and followed up for 6 to 18 months. Results Fifteen children with early LEV monotherapy had no or no EEG or epileptic seizures and then received combination therapy (LEV + short-range CZP). At the first and sixth months after treatment, 14 children with EEG were discharged (Only a small discharge in Rolandic area) or disappeared, complete control of seizures, ESES recurrence and epileptic seizure during one follow-up of 2 times, repeat the first and sixth months after the above combination regimen, the normal range of EEG, follow-up 8 months without seizures. Conclusions LEV combined with short-range CZP has relatively good control of ESES in children with BECCT with few side effects.