Kim Hunmin, Kim Soo Yeon, Lim Byung Chan, Hwang Hee, Chae Jong-Hee, Choi Jieun, Kim Ki Joong, Dlugos Dennis J
Department of Pediatrics, Seoul National University Bundang Hospital, Bundang, Republic of Korea; Pediatric Regional Epilepsy Center, Children's Hospital of Philadelphia, Philadelphia, PA, United States.
Pediatric Clinical Neuroscience Center, Seoul National University Children's Hospital, Seoul, Republic of Korea; Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Republic of Korea.
Brain Dev. 2018 Sep;40(8):693-698. doi: 10.1016/j.braindev.2018.04.011. Epub 2018 May 10.
This study was performed 1) to determine the timing of spike normalization in patients with benign epilepsy with centrotemporal spikes (BECTS); 2) to identify relationships between age of seizure onset, age of spike normalization, years of spike persistence and treatment; and 3) to assess final outcomes between groups of patients with or without spikes at the time of medication tapering.
Retrospective analysis of BECTS patients confirmed by clinical data, including age of onset, seizure semiology and serial electroencephalography (EEG) from diagnosis to remission. Age at spike normalization, years of spike persistence, and time of treatment onset to spike normalization were assessed. Final seizure and EEG outcome were compared between the groups with or without spikes at the time of AED tapering.
One hundred and thirty-four patients were included. Mean age at seizure onset was 7.52 ± 2.11 years. Mean age at spike normalization was 11.89 ± 2.11 (range: 6.3-16.8) years. Mean time of treatment onset to spike normalization was 4.11 ± 2.13 (range: 0.24-10.08) years. Younger age of seizure onset was correlated with longer duration of spike persistence (r = -0.41, p < 0.001). In treated patients, spikes persisted for 4.1 ± 1.95 years, compared with 2.9 ± 1.97 years in untreated patients. No patients had recurrent seizures after AED was discontinued, regardless of the presence/absence of spikes at time of AED tapering.
Years of spike persistence was longer in early onset BECTS patients. Treatment with AEDs did not shorten years of spike persistence. Persistence of spikes at time of treatment withdrawal was not associated with seizure recurrence.
本研究旨在：1）确定中央颞区棘波的良性癫痫（BECTS）患者棘波正常化的时间；2）确定癫痫发作起始年龄、棘波正常化年龄、棘波持续时间与治疗之间的关系；3）评估在逐渐减停药物时伴有或不伴有棘波的患者组之间的最终结局。
对经临床资料确诊的BECTS患者进行回顾性分析，包括发作起始年龄、发作症状学以及从诊断到缓解的系列脑电图（EEG）。评估棘波正常化时的年龄、棘波持续时间以及从开始治疗到棘波正常化的时间。比较在逐渐减停抗癫痫药物（AED）时伴有或不伴有棘波的患者组之间的最终癫痫发作和EEG结局。
纳入134例患者。癫痫发作的平均起始年龄为7.52±2.11岁。棘波正常化的平均年龄为11.89±2.11（范围：6.3 - 16.8）岁。从开始治疗到棘波正常化的平均时间为4.11±2.13（范围：0.24 - 10.08）年。癫痫发作起始年龄越小，棘波持续时间越长（r = -0.41，p < 0.001）。在接受治疗的患者中，棘波持续4.1±1.95年，而未接受治疗的患者中棘波持续2.9±1.97年。无论在逐渐减停AED时是否存在棘波，在停用AED后均无患者出现癫痫复发。
早发型BECTS患者的棘波持续时间更长。使用AED治疗并未缩短棘波持续时间。在停药时棘波的持续存在与癫痫复发无关。
