目的 探讨儿童良性癫痫伴中央颞区棘波(BECTS)变异型的儿童智商影响因素,为临床诊疗提供参考依据。方法 回顾性分析2010年1月-2015年1月就诊于新疆维吾尔自治区人民医院儿科的15例BECTS变异型患儿的临床特征(临床发作特点、智力及神经心理损害情况、脑电图特点、药物治疗反应等),并对BECTS变异型患儿语言量表各项分值与临床各因素进行相关性分析,对脑电图单侧和双侧异常放电部位的智商进行t检验比较。结果 66.7%的BECTS变异型患儿存在一定程度的学习障碍,15例视频脑电图均显示一侧或双侧中央、顶区和(或)中、后颞区(Rolandic 区)散在的棘慢波或棘波发放,睡眠后明显增多,部分达到睡眠期癫痫性电持续状态(ESES)现象。语言量表各项分值与非快速眼动(NREM)期棘慢波指数(SWI)≥50%持续时间、变异症状持续的时间呈负相关,单侧脑区及双侧脑区存在异常频繁放电两组之间智商差异无统计学意义。结论 BECTS变异型患儿存在认知损害,变异症状持续时间越长、NREM期SWI≥50%持续时间越长,认知功能损害越重。甲基强的松龙冲击联合抗癫痫药物可对大部分BECTS变异型患儿临床改善有效,对BECTS变异型患儿认知损害及语言发育的变化追踪是一个长期的过程。

Objective To study intelligence quotient influence factor in variant of benign childhood epilepsy with centrotemporal spikes (BECTS). Methods 15 cases of children with variant of BECTS in the pediatric ward of Xinjiang Uygur autonomous region people's hospital in January 2010 to January 2015 were researched retrospectively and the clinical features were analysed,which include clinical onset features,damage of intelligence and neuropsychological,electroencephalogram features,drug treatment response and so on.The correlation of language scale scores and clinical factors of children with variant of BECTS were analysed by correlation analysis.The t-test was used to compare the intelligence quotient of the unilateral and bilateral electroencephalogram abnormal discharges. Results 66.7% of variant of BECTS children showed a certain degree of learning disabilities,15 cases of electroencephalogram showed spine slow waves and spike waves which was discharged in central,top area and (or) posterior temporal area (Rolandic area) of unilateral or bilateral brain,which increased significantly after sleep and could partly reach to electrical status epilepticus during slow sleep(ESES).Language scale scores were correlated negatively with the duration of the spike slow wave index(SWI)≥50% in non rapid eye movement(NREM)term and the variant symptoms.There was no statistical significance in the difference of intelligence quotient between different abnormal discharged groups in unilateral and bilateral brain regions. Conclusions The children with variant of BECTS suffer cognitive impairment.The longer time of the duration of NREM SWI≥50% and variation symptom last,the more serious the cognitive dissonance is.The combined application of high doses methylprednisolone and the epilepsy drug is effective treatment for most variant of BECTS.