Nogovitsyn V Iu, Nesterovskiĭ Iu E, Osipova G N, Sandukovskaia S I, Kalinina L V, Mukhin K Iu
Zh Nevrol Psikhiatr Im S S Korsakova. 2004;104(10):48-56.
Incidence and significance of benign epileptiform discharges of childhood (BECD), or rolandic spikes, have been studied in 2723 children, aged 2-15 years, with (841 patients) and without (1882) epilepsy. All the patients underwent standard electroencephalographic (EEG) study with video-EEG monitoring made in cases of epileptiform abnormalities. In the non-epileptic group, BECD frequency was 1.33%. There was a significant predominance of boys in both groups. The age of maximal BECD expression was 4-5 years in the non-epileptic group and 9-10 years--in children with epilepsy. The majority of children without seizures demonstrated different neurological and neurocognitive abnormalities, such as chronic headaches (25%), attention deficit hyperactivity disorder (25%) and speech delay (21%). Epileptiform abnormalities were observed mostly in the right hemisphere in children with epilepsy and in the left hemisphere in non-epileptic patients. There was a morphological similarity of electroencephalographic patterns in patients with rolandic epilepsy, benign occipital epilepsy, pseudolennox syndrome, Landau-Kleffner syndrome and electrical status epilepticus during slow sleep. The authors conclude that BECD are nonspecific feature of rolandic epilepsy and can occur in the broad spectrum of disturbances forming "hereditary impairment of brain maturation" group. Hereditary mechanisms involved in realization of various electroclinical features of focal brain dysfunction are suggested.
对2723名年龄在2至15岁、患有癫痫(841例患者)和未患癫痫(1882例)的儿童进行了儿童良性癫痫样放电(BECD)或中央颞区棘波的发病率及意义的研究。所有患者均接受了标准脑电图(EEG)检查,对于癫痫样异常患者进行了视频脑电图监测。在非癫痫组中,BECD的发生率为1.33%。两组中男孩均显著居多。非癫痫组中BECD表达最明显的年龄为4至5岁,癫痫儿童为9至10岁。大多数无癫痫发作的儿童表现出不同的神经和神经认知异常,如慢性头痛(25%)、注意力缺陷多动障碍(25%)和语言发育迟缓(21%)。癫痫儿童的癫痫样异常大多出现在右半球,非癫痫患者则出现在左半球。中央颞区癫痫、良性枕叶癫痫、假 Lennox 综合征、Landau-Kleffner 综合征和慢波睡眠期癫痫持续状态患者的脑电图模式存在形态学相似性。作者得出结论,BECD是中央颞区癫痫的非特异性特征,可发生在构成“遗传性脑成熟障碍”组的广泛紊乱中。提示了涉及局灶性脑功能障碍各种电临床特征实现的遗传机制。