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目的探讨盐酸哌甲酯治疗儿童良性癫痫伴中央颞区棘波(BECTS)合并注意缺陷多动障碍(ADHD)的安全性及对癫痫发作的影响。方法选取2007年4月至2008年10月广州市儿童医院神经内科确诊的40例BECTS合并ADHD患儿,经抗癫痫药物治疗临床无发作达6个月以上,加用盐酸哌甲酯,每6个月复查1次脑电图(EEG),评价患儿注意力和行为改善情况,记录癫痫发作次数、类型以及其他副反应,将患儿用药前后的癫痫发作情况进行自身对照研究。结果 40例中37例用药时间超过6个月,注意力、多动及对立违拗行为明显改善。4例发生副反应;2例用药1周内发作增多;1例用药1年后出现1次发作;1例用药2d内出现入睡困难,停药后发作及入睡困难停止。患儿服用盐酸哌甲酯前后癫痫发作及其他副反应出现情况差异无统计学意义(P>0.05)。结论抗癫痫药控制临床发作的同时,在规范剂量范围内使用盐酸哌甲酯治疗BECTS合并ADHD具有安全性。
Objective To investigate the safety and safety of methylphenidate hydrochloride in the treatment of children with benign epilepsy and central temporal thrombosis (BECTS) and attention deficit hyperactivity disorder (ADHD). Methods From April 2007 to October 2008, 40 children with BECTS complicated with ADHD diagnosed in Department of Neurology, Children’s Hospital of Guangzhou City were enrolled and treated with antiepileptic drugs for no more than 6 months. Methylphenidate Month EEG was reviewed to evaluate the attention and behavior of the children. The number of epileptic seizures, the type and other side effects were recorded. The self-control study was conducted on the seizures in children before and after treatment. Results Of the 40 cases, 37 cases were treated for more than 6 months, their attention, hyperactivity and antagonistic behavior were significantly improved. 4 cases of side effects; 2 cases of seizure increased within 1 week; 1 case of drug 1 year after the onset of an attack; 1 case of medication within 2d difficulty falling asleep, after stopping the attack and difficulty falling asleep. Children taking methylphenidate before and after seizures and other side effects occurred no significant difference (P> 0.05). Conclusions Although antiepileptic drugs can control clinical seizures, it is safe to use methylphenidate hydrochloride in the treatment of BECTS complicated with ADHD in the standard dosage range.