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目的研究学龄期局灶性癫患儿发作间期睡眠结构的变化。方法应用Solar2000N神经中央监护系统对23例6～12岁局灶性癫患儿(男15例,女8例)及15例年龄、性别与之相匹配的健康儿童(健康对照组,男11例,女4例)进行全夜自然睡眠多导监测,并将23例局灶性癫患儿按照样放电出现部位(额叶癫组、颞叶癫组、枕叶癫组),发作好发时间(睡眠发作组、清醒发作组、睡眠+清醒发作组)及服用抗癫药物类型(卡马西平治疗组,卡马西平+托吡酯治疗组)进行分组,应用SPSS13.0软件分析各组患儿与健康儿童之间各项睡眠参数的差异。结果与健康对照组比较,学龄期局灶性癫患儿非快速眼动(NREM)睡眠1期比例延长(P<0.05),慢波睡眠(SWS)比例显著减少(P<0.01);额叶癫组各项睡眠参数与健康对照组比较差异无统计学意义,颞叶癫组患儿NREM睡眠1期比例及觉醒时间延长(Pa<0.05),枕叶癫组SWS比例与健康对照组比较差异有统计学意义(P<0.05);睡眠发作组觉醒次数增加(P<0.05),NREM睡眠1期比例增加(P<0.05),清醒发作组SWS比例减少(P<0.05);卡马西平+托吡酯组与未服药组比较,快速眼动(REM)睡眠时间增加(P<0.05)。结论学龄期局灶性癫患儿浅睡眠增多,深睡眠减少,以NREM1期睡眠增多为主;颞叶癫显示了更多的觉醒时间;易在睡眠中发作的癫患儿觉醒次数增加;卡马西平+托吡酯治疗可增加局灶性癫患儿的REM睡眠时间。
Objective To study the change of sleep structure in children with school-age focal epilepsy. Methods A total of 23 children with focal epilepsy aged 6-12 years (15 males and 8 females) and 15 healthy children (healthy control group, male 11 (N = 4, female, n = 4) underwent nocturnal natural sleep monitoring. Twenty-three patients with focal epilepsy were divided into two groups according to the type of discharge (frontal lobe epilepsy group, temporal lobe epilepsy group, occipital lobe epilepsy group) ), Seizure onset time (sleep-onset group, conscious-onset group, sleep-wakefulness group) and anti-epileptic drug type (carbamazepine treatment group and carbamazepine + topiramate treatment group) Software analysis of various groups of children and healthy children between the various sleep parameters. Results Compared with the healthy control group, the proportion of non-REMEM sleep stage 1 (P <0.05) and SWS (P0.01) in school-age children with focal epilepsy were significantly decreased There was no significant difference in the sleep parameters between the epilepsy group and the healthy control group (P <0.05). The proportion of NREM sleep in the temporal lobe epilepsy group and the awakening time were prolonged (P <0.05) (P <0.05). The number of awake in sleep episode increased (P <0.05), the proportion of NREM sleep increased in one phase (P <0.05), and the proportion of SWS in conscious episode decreased (P <0.05). Compared with the non-medication group, the REM sleep time increased in the carbamazepine + topiramate group (P <0.05). Conclusions Children with focal epilepsy in school age have increased numbers of light sleep and dark sleep, with predominantly increased sleep in NREM1. Temporal lobe epilepsy shows more awakening time. The number of awake children with epilepsy Increase; carbamazepine + topiramate treatment can increase REM sleep time in children with focal epilepsy.