Kanemura Hideaki, Sano Fumikazu, Ohyama Tetsuo, Sugita Kanji, Aihara Masao
Department of Pediatrics, Faculty of Medicine, University of Yamanashi, Japan.
Department of Pediatrics, Faculty of Medicine, University of Yamanashi, Japan.
Seizure. 2014 Sep;23(8):646-50. doi: 10.1016/j.seizure.2014.05.006. Epub 2014 May 19.
The prognosis of rolandic epilepsy (RE) is considered favorable. Since a moderate proportion of cases presents with isolated seizures, continuous treatment should be considered only for frequent seizures. Clinical and electroencephalogram (EEG) markers to predict seizure recurrence need to be identified. The purpose of this study was to identify EEG criteria related to seizure recurrence in RE.
There were 10 children (aged 3-10 years; 6 males, 4 females) in the recurrence group and 12 (aged 4-7 years; 6 males, 6 females) in the isolated group. Occurrences of the number of spikes were scored, and the presence of rolandic discharges (RD) in the awake record was evaluated. All patients were evaluated longitudinally, clinically and by EEG, with repeated EEG recordings every 3 months. Clinical and EEG follow-up was performed for ≥4 years.
Seizure recurrence and extended periods of high-frequency paroxysmal EEG abnormalities (>6 months after onset) were significantly correlated (p<0.001). Moreover, the appearance of RD in awake recordings tended to be more prevalent in the recurrence group than in the isolated group (odds ratio 4.714).
In addition to RD in the awake record, a combination of spike rate and extended periods of high-frequency paroxysmal EEG abnormalities may predict seizure recurrence in RE.
罗兰多癫痫（RE）的预后被认为是良好的。由于相当一部分病例表现为孤立发作，因此仅对频繁发作的情况才应考虑持续治疗。需要确定预测癫痫发作复发的临床和脑电图（EEG）指标。本研究的目的是确定与RE中癫痫发作复发相关的EEG标准。
复发组有10名儿童（年龄3 - 10岁；男6名，女4名），孤立发作组有12名儿童（年龄4 - 7岁；男6名，女6名）。对棘波数量的出现情况进行评分，并评估清醒记录中罗兰多放电（RD）的存在情况。所有患者均进行纵向临床和EEG评估，每3个月重复进行EEG记录。临床和EEG随访时间≥4年。
癫痫发作复发与高频阵发性EEG异常的延长时间（发作后>6个月）显著相关（p<0.001）。此外，清醒记录中RD的出现复发组比孤立发作组更常见（优势比4.714）。
除了清醒记录中的RD外，棘波率和高频阵发性EEG异常的延长时间相结合可能预测RE中的癫痫发作复发。
