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《Journal of Applied Clinical Pediatrics》 2012-24
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Clinical Characteristics and Prognosis of Idiopathic Occipital Epilepsy and Electrical Status Epilepticus in Sleeping Children

ZHANG Sheng,LUO Xu-feng,FU Si-mao,ZHU Jiang-ping,WU Tao(Department of Pediatrics,Boai Hospital of Zhongshan City Affiliated to Nanfang Medical University,Zhongshan 528403,Guangdong Pro-vince,China)  
Objective To investigate the clinical manifestations,electroencephalogram(EEG) characteristics,treatment response and prognosis of children with idiopathic occipital epilepsy and electrical status epilepticus in sleep(ESES).Methods Clinical and EEG data of 8 cases with idiopathic occipital epilepsy and ESES were analyzed together with follow-up for treatment and prognosis.Results The onset age varied from 5 years and 8 months to 8 years and 4 months in the 8 cases.All the 8 cases had neuropsychological injury and motor regression,but had no history of family epilepsy and clear abnormalities by brain imaging examination.Seven patients had seizures,performing exercise-induced limited seizures after waking up;seizures could also attack during awaking period,including exercise-induced limited seizures(5/7 cases) and overall tonic-clonic seizures(2/7 cases).Antiepileptic drugs(AEDs) reduced attacks in 4 cases,but did not improve the psychological damage to nerve and motor regression obviously.Mild improvement in neuropsychological injury and EEG were observed in 3 cases treated with single drug Oxcarbazepine(OXC).Six cases,who were treated with intravenous methylprednisolone shock therapy,had ideal control,and 1 case had marked improvement of nerve injury and psychological setback in movement.Eight patients were followed up by EEG for 0.5-2.0 years,and 2 cases improved in ESES phenomenon.Up to follow-up,the 8 cases of patients still had mental retardation compared with healthy children in the same age.Conclusions Idiopathic occipital epilepsy is an age-dependent benign epilepsy in children;AEDs are often ineffective when the EEG showes ESES of the patients;hormones can reduce the clinical attack,but can not improve the psychological nerve damage and phenomenon of EEG ESES.Children with poor response to corticosteroids can be treated with OXC monothe-rapy or combined therapy.
【CateGory Index】: R742.1
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