儿童睡眠中癫痫性电持续状态36例临床分析

目的：总结儿童睡眠中癫痫性电持续状态（ESES）的临床、脑电图（EEG）、神经心理障碍的特点及对治疗的反应。方法：对36例ESES患儿进行V—EEG监测，随访观察临床、EEG、神经心理障碍的情况以及治疗效果。结果：36例中27例（75oA）经治疗临床发作完全控制或明显减少，EEG上ES—ES消失。22例使用肾上腺皮质激素甲基泼尼松龙冲击治疗中的17例（77％）在临床发作改善和抑制痫样放电方面都有良好的疗效。32例神经心理障碍患儿26例（81％）经治疗后有明显改善。结论：ESES是一种特殊的EEG现象，非快速眼动（NREM）睡眠期持续放电是神经心理障碍的主要原因。抗癫痫治疗除控制其临床癫痫发作外，还必须及早消除EEG痫样放电持续状态。

The clinical analysis of 36 children with electrical status epilepticus during sleep

Objective ： To summarize the clinical, electroencephalogram（EEG） and neuropsychological impediment characteristics of children with electrical status epilepticus during sleep（ESES）, and the response to therapy. Methods： V-EEG including an entire sleeping cycle was performed in 36 patients with ESES. The changes of clinical, EEG, neuropsychological impediment and the response to therapy were followed up. Results： In 27 cases （75 % ） of 36 patients, clinical seizures stopped or decreased significantly and ESES disappeared on EEG after treatment,and 22 cases with adrenal cortex hormones had the effectacy rate of 77% （17 cases）. Methylprednisolone pulse therapy on the improvement of clinical seizures and inhibition of epileptic discharges have were rather effective. Thirty-two cases of neuropsychological impediment in children with significant improvement in 26 cases （81%）. Conclusion： ESES is a specific EEG phenomenon. Continuous epileptic discharge during non-rapid eye movemont sleep（NREM） is the major cause for neuropsychological impediment in patients with ESES. Antiepileptie therapy should not only control clinical seizures, but also inhibit epileptic discharge.