本文關(guān)鍵詞： 睡眠中癲癇性電持續(xù)狀態(tài)(ESES) 左乙拉西坦(LEV) 腦電圖(EEG) 兒童　出處：《中國人民解放軍軍醫(yī)進(jìn)修學(xué)院》2012年碩士論文　論文類型：學(xué)位論文

【摘要】：目的兒童睡眠中癲癇性電持續(xù)狀態(tài)(ESES)是一種特殊的腦電圖現(xiàn)象,發(fā)生率占兒童癲癇的0.2%-0.5%,主要指非快動(dòng)眼(NREM)睡眠期持續(xù)廣泛棘慢波發(fā)放占整個(gè)NREM期的85%以上,伴或不伴癲癇發(fā)作。ESES不是一個(gè)獨(dú)立的癲癇綜合征,而是包括了一系列不同病因、不同臨床表現(xiàn)及不同預(yù)后的多種癲癇綜合征,目前尚無統(tǒng)一治療方法。本課題通過總結(jié)分析27例ESES患兒對(duì)左乙拉西坦(levetiracetam,LEV)治療的反應(yīng),探討臨床應(yīng)用左乙拉西坦治療兒童ESES的可行性。 方法將本院2009年8月至2011年3月首診的27例ESES患兒按照使用LEV治療的時(shí)相分成A、B兩組,對(duì)其臨床發(fā)作控制情況及腦電圖(electroencephalogram, EEG)改善情況隨訪至少6個(gè)月,分別觀察其使用LEV治療的效果,分析LEV治療兒童ESES的療效。 結(jié)果27例ESES患兒,男17例,女10例,起病年齡9月～9歲7月,起病早期89%的患兒為局限性運(yùn)動(dòng)發(fā)作。A組23例為ESES確診后加用LEV,其中19例歸屬于兒童良性癲癇伴中央顳區(qū)棘波(BECT),4例為非BECT的ESES。LEV開始治療年齡為1歲8月～11歲9月,隨訪時(shí)間為7-19個(gè)月。LEV控制臨床發(fā)作有效率為82%,改善腦電圖(EEG)情況有效率為78%。LEV控制臨床發(fā)作效果優(yōu)于改善EEG效果(P=0.00080.05)。B組4例(15%)ESES患兒于ESES出現(xiàn)前已加用LEV,并未能阻止ESES的發(fā)生。 結(jié)論LEV在控制臨床發(fā)作和改善腦電圖放電方面均有一定療效,可用于臨床ESES患兒的治療。4例ESES患兒在ESES前已加用LEV,提示LEV的使用可能并不能阻止ESES的出現(xiàn)。
[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.
【學(xué)位授予單位】：中國人民解放軍軍醫(yī)進(jìn)修學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R742.1

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