Zhang Bo, Chen Tianyu, Hao Xiaosheng, Xin Meiying, Liang Jianmin
Department of Pediatric Neurology, First Hospital of Jilin University, Changchun, China.
Jilin Provincial Key Laboratory of Pediatric Neurology, Changchun, China.
Front Pediatr. 2023 Mar 9;11:994817. doi: 10.3389/fped.2023.994817. eCollection 2023.
The objective of this study was to better understand the clinical features of photosensitive epilepsy (PSE) in Chinese children.
Thirty-one children with PSE were screened out of 398 children with epilepsy who were consecutively diagnosed by the video-electroencephalogram (VEEG) monitoring method and by using an intermittent photic stimulation (IPS) test. Their EEGs and clinical features were retrospectively analyzed, and their treatment outcomes were followed up.
PSE accounted for 7.79% (31/398) of children with epilepsy during the observation period in our single epilepsy center. The male to female ratio of PSE was 1:3.43, and the average seizure onset age was 7.8 ± 3.28 years. The highest range of frequency sensitivity of the IPS test for the induction of EEG epileptic discharge or electroclinical seizures was within 10-20 Hz. Electroclinical seizures were induced in 41.94% (13/31) of PSE patients by using the IPS test, while EEG discharge without clinical seizures was induced in 58.06% (18/31) of PSE patients. Among all PSE patients, an IPS-positive reaction in the eye-closure state was induced in 83.87% of patients, and this rate was significantly higher than that in the eye-opened state (41.94%) or eye-closed state (35.48%). (Eye-closure IPS stimulation means: make the subjects close their eyes at the beginning of each stimulation, open their eyes at the end of the stimulation, and close their eyes again at the beginning of the next stimulation, and so on. While Eye-closed IPS stimulation means the stimulation is started after 5 s of eye closure, and the subjects are kept closed throughout the whole process.) The common and effective drugs used for single or combined therapy in PSE children were valproic acid and levetiracetam.
This study provides some useful information about electroclinical characteristics in a cohort of 31 PSE children. It may be beneficial for pediatric neurologists in terms of paying more attention to PSE and correctly dealing with it.
本研究的目的是更好地了解中国儿童光敏性癫痫（PSE）的临床特征。
在398例通过视频脑电图（VEEG）监测方法连续诊断的癫痫患儿中，通过间歇性光刺激（IPS）试验筛选出31例PSE患儿。对他们的脑电图和临床特征进行回顾性分析，并对其治疗结果进行随访。
在我们单一的癫痫中心观察期内，PSE占癫痫患儿的7.79%（31/398）。PSE的男女比例为1:3.43，平均癫痫发作起始年龄为7.8±3.28岁。IPS试验诱发脑电图癫痫放电或电临床发作的频率敏感性最高范围在10 - 20Hz之间。通过IPS试验，41.94%（13/31）的PSE患者诱发了电临床发作，而58.06%（18/31）的PSE患者诱发了无临床发作的脑电图放电。在所有PSE患者中，83.87%的患者在闭眼状态下出现IPS阳性反应，该比例显著高于睁眼状态（41.94%）或睁闭眼交替状态（35.48%）。（闭眼IPS刺激方式：在每次刺激开始时让受试者闭眼，在刺激结束时睁眼，在下一次刺激开始时再次闭眼，依此类推。而持续闭眼IPS刺激方式是在闭眼5秒后开始刺激，受试者在整个过程中保持闭眼。）PSE患儿单药或联合治疗常用且有效的药物是丙戊酸和左乙拉西坦。
本研究为31例PSE患儿的电临床特征提供了一些有用信息。这可能有助于儿科神经科医生更多地关注PSE并正确处理。
