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目的 探讨睡眠中癫痫性电持续状态 (ESES)的临床、脑电图 (EEG)特征及治疗特点。方法 用 2 4小时便携式EEG或 4～ 8小时Video -EEG进行监测 ,以睡眠中限局性或广泛性棘慢波持续发放 ,达到或超过非眼快动期 (NREM)睡眠时间的 85 %作为ESES的诊断标准。结果 共有 12例各种类型的癫痫综合征患儿具有ESES的EEG特征 ,其共同特点为年龄依赖性发病 ,多种发作形式 ,慢波睡眠期持续棘慢波发放 ,精神发育或认知功能倒退 ,对氯硝基安定及丙戊酸治疗反应良好。结论 ESES不是一个独立的癫痫综合征 ,而是一种特殊的EEG现象。长时间的持续睡眠中癫痫性放电是ESES引起高级皮层功能损伤的主要原因。抗癫痫药物治疗不仅要控制癫痫发作 ,而且应有效抑制EEG的癫痫性电活动。
Objective To explore the clinical features of EEG and therapeutic characteristics of sleep-deprived epileptic electric state (ESES). Methods 24 hours of portable EEG or 4 ~ 8 hours of Video-EEG monitoring, continuous sleep in the limited or regional spikes and waves continue to meet, or exceed 85% of non-eye fasting period (NREM) sleep time as ESES Diagnostic criteria. Results A total of 12 children with various types of epilepsy syndrome were found to have EEG features of ESES. Their common features were age-related onset, multiple seizure patterns, spike-and-slow wave delivery in slow wave sleep, mental development or cognitive decline , Good response to clonazepam and valproate. Conclusion ESES is not an independent epilepsy syndrome, but a special EEG phenomenon. Prolonged epileptic discharge during prolonged sleep is a major cause of ESES-induced damage to the superior cortical function. Antiepileptic drug therapy should not only control seizures, but also effectively inhibit epileptic electrical activity of EEG.