Tacke Moritz, Gerstl Lucia, Heinen Florian, Heukaeufer Isabel, Bonfert Michaela, Bast Thomas, Cornell Sonia, Neubauer Bernd Axel, Borggraefe Ingo
Department of Pediatric Neurology, Developmental Medicine and Social Pediatrics, University of Munich, Germany.
Department of Pediatric Neurology, Developmental Medicine and Social Pediatrics, University of Munich, Germany.
Eur J Paediatr Neurol. 2016 Nov;20(6):874-879. doi: 10.1016/j.ejpn.2016.07.015. Epub 2016 Jul 25.
Benign epilepsy with centrotemporal spikes (BECTS) is a common epilepsy syndrome in childhood. Besides the occurrence of seizures, mild cognitive impairments and behavioral problems affecting language skills, spatial perception, memory, executive function, and academic achievement might be present. There is no international consensus about the decision whether or not to treat affected children. The influence of treatment on cognitive functions is debated.
Patients diagnosed with BECTS were assessed in short term auditory memory, long-term verbal memory, intelligence and behavior using the "number recall" test from the Kaufman assessment battery for children, the "verbal learning memory test", the "culture free intelligence test" and the "child behavior checklist" prior to a randomized controlled antiepileptic therapy and after a treatment period of 6 months with either sulthiame or levetiracetam.
43 of 44 randomized patients were analyzed. One patient had to be excluded due to protocol violation. Patients who completed the study showed a non-significant improvement in parent-reported behavioral problems under therapy. Cognitive skills were not affected.
The present data suggest that antiepileptic drug treatment of children with BECTS with either sulthiame or levetiracetam does not affect cognitive performance. Behavior improved in a subset of patients though not reaching statistical significance.
伴中央颞区棘波的儿童良性癫痫(BECTS)是儿童期常见的癫痫综合征。除了癫痫发作外,还可能存在影响语言技能、空间感知、记忆、执行功能和学业成绩的轻度认知障碍及行为问题。对于是否治疗患病儿童尚无国际共识。治疗对认知功能的影响存在争议。
对诊断为BECTS的患者在随机对照抗癫痫治疗前,以及使用考夫曼儿童评估量表中的“数字回忆”测试、“言语学习记忆测试”、“非文字智力测试”和“儿童行为量表”对短期听觉记忆、长期言语记忆、智力和行为进行评估,并在使用舒噻美或左乙拉西坦治疗6个月后再次评估。
44例随机分组患者中的43例进行了分析。1例患者因违反方案被排除。完成研究的患者在治疗期间家长报告的行为问题有非显著性改善。认知技能未受影响。
目前的数据表明,使用舒噻美或左乙拉西坦对BECTS患儿进行抗癫痫药物治疗不会影响认知表现。一部分患者的行为有所改善,但未达到统计学意义。