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甲泼尼龙冲击治疗对儿童睡眠中癫痫性电持续状态的疗效 被引量:17

Efficacy of methylprednisolone therapy for electrical status epilepticus during sleep in children
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摘要 目的 探讨甲泼尼龙冲击对儿童睡眠中癫痫性电持续状态(ESES)的治疗效果.方法 2007年7月至2012年9月收集北京大学第一医院儿科收治的82例伴ESES现象的癫痫综合征病例[包括儿童良性癫痫伴中央颞区棘波(BECT)变异型、癫痫伴慢波睡眠期持续棘慢波(CSWS)、Landau-Kleffner综合征(LKS)]进行回顾性分析,所有病例均给予甲泼尼龙15 ~20 mg/(kg·d),每疗程用3d、停4d,期间给予口服泼尼松1~2 mg/(kg·d),连续用3个疗程.停药出院后继续给予口服泼尼松序贯治疗,2周后逐渐减量,总疗程6个月.分析甲泼尼龙冲击治疗对ESES的疗效及在三种癫痫综合征中的疗效差异.结果 本组患儿男39例,女43例,BECT变异型49例,CSWS 27例及LKS 6例.发病年龄1岁4个月~11岁,首次监测到ESES的年龄为2岁~10岁8个月.甲泼尼龙冲击治疗对ESES的总有效率为83% (68/82),其中BECT变异型82% (40/49),CSWS 81%(22/27),LKS 100% (6/6),前两者在疗效上差异无统计学意义(x2 =0.09,P>0.05).治疗后1个月内癫痫发作次数总体明显减少.随访1年后BECT变异型病例1年内复发率为47% (23/49),CSWS病例复发率为59% (16/27),LKS病例中ESES复发率为50% (3/6).激素冲击治疗对SWI的短期疗效与发病年龄、ESES持续时间无明显相关性(x2=3.585、0.932,P>0.05).结论 甲泼尼龙冲击治疗对三种癫痫综合征ESES现象及癫痫发作均有一定疗效;对ESES的疗效与发病年龄、ESES持续时间无明显相关性. Objective To evaluate the therapeutic effect of methylprednisolone for electrical status epilepticus during sleep (ESES) in children.Method The clinical and EEG data of 82 epilepsy patients with ESES,which included benign childhood epilepsy with centro temporal spikes (BECT) variants,epilepsy with continuous spikes and waves during slow sleep (CSWS),Landau-Kleffner syndrome (LKS) collected from department of pediatrics,Peking University First Hospital were analyzed from July 2007 to September 2012.During ESES period,all patients received methylprednisolone treatment for three courses,which included methylprednisolone intravenous infusion for three days,followed by oral prednisone for four days every time.After three courses,prednisone [1-2 mg/(kg · d)] were taken by all patients for 6 months.The ESES phenomenon and seizures were observed before and after treatment.The efficacy of corticosteroid on ESES suppression,seizure control of three epilepsy syndrome were analyzed.Result Thirty-nine cases were male and 43 cases were female.The epilepsy syndromes included 49 patients diagnosed as benign childhood epilepsy with centrotemporal spike (BECT) variants,27 patients diagnosed as epilepsy with continuous spikes and waves during slow sleep (CSWS),and 6 patients diagnosed as LKS.Age of onset ranged from 1 year and 4 months to 11 years.The age of ESES newly monitored was from 2 years to 10 years and 8 months.The total effective rate of corticosteroid was 83% (68/82) for ESES,BECT variants was 82% (40/49),CSWS was 81% (22/27),LKS was 100% (6/6).There was no statistically significant difference in effective rates between the front two (x2 =0.09,P > 0.05).The seizures were improved in the first month after methylprednisolone treatment in 3 epilepsy syndromes.The recurrence rate of BECT variants was 47% (23/49),CSWS was 59% (16/27),LKS was 50% (3/6)after 1 year follow up.There was no association between disease parameters,including age at seizure o
作者 陈静 杨志仙 刘晓燕 季涛云 符娜 吴晔 熊晖 王爽 常杏芝 Chen Jing,Yang Zhixian,Liu Xiaoyan,Ji Taoyun,Fu Na,Wu Ye,Xiong Hui( 1.The first author is now in Department of Neurology, Nanjing Children's Hospital Affiliated to Nanjing Medical University, Nanjing 210008, China; 2.Department of Pediatrics, Peking University First Hospital, Beijing 100034, China)
出处 《中华儿科杂志》 CAS CSCD 北大核心 2014年第9期678-682,共5页 Chinese Journal of Pediatrics
基金 北京大学-清华大学生命科学联合中心临床培育平台项目
关键词 癫痫 睡眠 甲泼尼龙 疗效对比研究 Epilepsy Sleep Methylprednisolone Comparative effectiveness research
作者简介 通信作者:杨志仙(Email:zhixian.yang@163.com)
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参考文献18

  • 1Patry G,Lyagoubi S,Tassinari CA.Subclinical "electrical status epilepticus" induced by sleep in children:a clinical and electroencephalographic study of six cases[J].Arch Neurol,1971,24:242-252. 被引量:1
  • 2Tassinari CA,Cantalupo G,Rios-Pohl L,et al.Encephalopathy with status epilepticus during slow sleep:" the penelope syndrome"[J].Epilepsia,2009,50 Suppl 7:4-8. 被引量:1
  • 3Galanopoulou AS,Bojko A,Lado F,et al.The spectrum of neuropsychiatric abnormalities associated with electrical status epilepticus in sleep[J].Brain Dev,2000,22:279-295. 被引量:1
  • 4Caraballo RH,Veggiotti P,Kaltenmeier MC,et al.Encephalopathy with status epilepticus during sleep or continuous spikes and waves during slow sleep syndrome:a multicenter,longterm follow-up study of 117 patients[J].Epilepsy Res,2013,105:164-173. 被引量:1
  • 5Kramer U,Sagi L,Goldberg-Sterm H,et al.Clinical spectrum and medical treatment of children with electrical status epilepticus in sleep (ESES)[J].Epilepsia,2009,50:1517-1524. 被引量:1
  • 6Sorel L,Dusaucy-Bauloye A.Findings in 21 cases of Gibbs' hysarrhythmia; spectacular effectiveness of ACTH[J].Acta Neurol Psychiatr Belg,1958,58:130-141. 被引量:1
  • 7Marescaux C,Hirsch E,Finck S,et al.Landau-Kleffner syndrome:a pharmacologic study of five cases[J].Epilepsia,1990,31:768-777. 被引量:1
  • 8Tsuru T,Mori M,MizuguchiM,et al.Effects of high-dose intravenous corticosteroid therapy in Landau-Kleffner syndrome[J].Pediatr Neurol,2000,22:145-147. 被引量:1
  • 9Loiseau P,Beaussart M.The seizures of benign childhood epilepsy with Rolandic paroxysmal discharges[J].Epilepsia,1973,14:381-389. 被引量:1
  • 10Panayiotopoulos CP.The epilepsies:seizures,syndromes and management[M].Oxford shire (UK):Blad on Medical Publishing,2005:183-189. 被引量:1

二级参考文献31

  • 1刘晓燕,张月华,包新华,吴晔,王爽,常杏芝,秦炯.儿童良性癫癎伴中央颞区棘波的变异型[J].中国循证儿科杂志,2006,1(1):33-39. 被引量:18
  • 2Capovilla C, Beccaria F, Cagdas S, et al. Efficacy of levetiraeetam in phaIxnaeoresistant continuous spikes and waves during slow sleep [ J ]. Acta Neurol Scand,2004,110 (3) : 144 - 147. 被引量:1
  • 3Aeby A, Poznanski N, Verheulpen D,et al. Levetiraeetam efficacy in epileptic syndromes with continuous spikes - and - waves during sleep : Experience in 12 cases[J]. Epilepsia ,2005,46(12) :1937 - 1942. 被引量:1
  • 4Kramer U, Sagi L,Goldberg- Stern H,et al. Clinical spectrum and medical treatment of children with electrical status epilepticus in sleep (ESES) [J]. Epilepsia,2009,50(6) :1517 - 1524. 被引量:1
  • 5Wang SB,Weng WC, Fan PC, et al. Levefiracetam in continuous spike waves during slow - wave sleep syndrome [ J ]. Pediatr Neurol, 2008,39 (2) :85 -90. 被引量:1
  • 6Lagae L. Rational treatment options with AEDs and ketogenic diet in Landau- Kleffner syndrome:Still waiting after all these years [J].Epilepsia ,2009 ,50 ( suppl 7 ) :59 - 62. 被引量:1
  • 7Veggiotti P, Beccaria F, Guerrini R,et al. Continuous spike and wave activity during slow - wave sleep : Syndrome or EEG pattern [J].Epilepsia, 1999,40( 11 ) : 1593 - 1601. 被引量:1
  • 8lnutsuka M, Kobayashi K, Oka M ,et al. Treatment of epilepsy with electrical status epilepticus during slow sleep and its related disorders [J]. Brain,2006,28 ( 5 ) :281 - 286. 被引量:1
  • 9Glauser TA. Topiramate in the catastrophic epilepsies of childhood [J]. J Child Nezzro1,2000,15 ( suppl 1 ) : 14 - 21. 被引量:1
  • 10Gallagher MJ, Eisenman LN, Brown KM, et al. I,evetiracetam reduces spike - wave density and duration during continuous EEG monitoring in patients with idiopathic generalized epilepsy [ J ]. Epilepsia, 2004,45 (1) :90 -91. 被引量:1

共引文献147

同被引文献135

  • 1解读国际抗癫痫联盟和癫痫局癫痫及癫痫发作新定义[J].中华医学杂志,2007,87(29):2023-2024. 被引量:14
  • 2陈勇,钟建民,吴华平,等.甲基泼尼松龙冲击治疗儿童睡眠中癫痫性电持续状态的临床分析[C].第三届CAAE中国脑电图和神经电生理大会论文摘要集,2012,19(27):106-107. 被引量:2
  • 3王傲雪,张荣鑫,高玉雪,等.抗癫痫药所致的药物超敏反应综合征1例报告[C]//第五届全国中西医结合变态反应学术会议论文集.北京:中国中西医结合学会,2011. 被引量:1
  • 4Wanigasinghe J,Arambepola C,Sri Ranganathan S,et al.The efficacy of moderate-to-high dose oral prednisolone versus low-to-moderate dose intramuscular corticotropin for improvement of hypsarrhythmia in West syndrome:a randomized,single-blind,parallel clinical trial[J].Pediatr Neurol,2014,51(1):24-30. 被引量:1
  • 5Crino PB,Nathanson KL,Henske EP.The Tuberous Sclerosis Complex[J].N Engl J Med,2006,355:1 345-1 356. 被引量:1
  • 6Yang G,Yang L,Yang X,et al.Efficacy and safety of a mammalian target of rapamycin inhibitor in pediatric patients with tuberous sclerosis complex:A systematic review and meta-analysis[J].Exp Ther Med,2015,9(2):626-630. 被引量:1
  • 7Xie L,Sun F,Wang J,et al.mTOR signaling inhibition modulates macrophage/microglia-mediated neuroinflammation and secondary injury via regulatory T cells after focal ischemia[J].J Immunol,2014,192(12):6 009-6 019. 被引量:1
  • 8D'Ambrosio R,Eastman CL,Fattore C,et al.Novel frontiers in epilepsy treatments:preventing epileptogenesis by targeting inflammation[J].Expert Rev Neurother,2013,13(6):615-625. 被引量:1
  • 9Marchi N,Granata T,Janigro D.Inflammatory pathways of seizure disorders[J].Trends Neurosci,2014,37(2):55-65. 被引量:1
  • 10Devinsky O,Vezzani A,Najjar S,et al.Glia and epilepsy:excitability and inflammation[J].Trends Neurosci,2013,36(3):174-184. 被引量:1

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