Research On Clinical Significance Of Scalp High-frequency Electroencephalogram On Childhood Epilepsy Syndrome

PART ONE Investigation of Clinical Significance of Scalp High-frequency Electroencephalogram to predict poor prognosis of Childhood Benign Epilepsy with Centrotemporal SpikePurposeTo explore a method of recording high-frequency oscillations(HFOs)by scalp electroencephalogram(EEG).To analyze the relationship between HFOs and the poor prognosis of childhood benign epilepsy with centrotemporal spike(BECTS).Methods62 cases with BECTS were enrolled randomly and followed up for two years.Scalp EEG and intelligence quotient(IQ)test were performed every six months.HFOs were detected by scalp EEG with high sampling rate.All cases were divided into two groups according to the number of anti-epileptic drugs and the seizure outcome,named as"benign group" and "non-benign group".IQ and EEG results were compared between two groups.The characteristics of HFOs were observed and described.The relationship between HFOs and the prognosis of BECTS patents were analyzed.ResultsThere were 52 cases on the "benign" group,10 cases on the "non-benign" group eventually.HFOs were detected on 4 cases from "non-benign" group.The frequencies,amplitudes and durations of them were 83.3-172.4Hz,5-25μV and 80-200ms respectively.HFOs were superimposed on the phase of spike,however the characteristics was significantly different.Electrical status epilepticus during sleep(ESES)were found successively on 12 cases by the routine video-EEG.After statistical analysis,both of HFOs and ESES were related to the prognosis.However,HFOs appeared earlier and more steadily than ESES,they were more distinctly related with the prognosis than ESES.Conclusion1.We had firstly detected HFOs by scalp high-frequency EEG on BECTS in China.2.HFOs can predict the poor seizure outcome and impaired intelligence on BECTS earlier and more accurately.PART TWO Investigation of the clinical significance of scalp high-frequency Electroencephalogram on Epileptic encephalopathy with continuous spike and waves during slow sleepPurposeTo investigate the clinical significance of scalp EEG high frequency oscillations(HFOs)on children with epileptic encephalopathy with continuous spike-and-wave during sleep(CSWS)treated by Methylprednisolone pulse(mPSL-P).Methods30 children with CSWS were enrolled.HFOs were detected and analyzed.The children who were detected HFOs were treated by mPSL-P.The children were divided into two groups based on the early seizure outcome(2 weeks post therapy),"effective group" if seizure reduction ratio ≥50%,conversely "ineffective group".The "effective group" was furtherly divided into two subgroups("relapse" and "non-relapse" subgroups)according to the seizure outcome during one-year follow-up.ResultsHFOs were detected in 22 subjects at the baseline.There were 18 cases on the effective group,4 cases on the ineffective group.11 cases had relapsed during one-year follow-up.The relapse rate was 61.1%.The detection rate of HFOs had significant difference among the three subgroups.However,that of ESES did not.On the relapse group(n=11),the detection rate of HFOs was significantly higher than that of ESES except the last follow-up.The average IQ was improved significantly only on the non-relapse group.The disappearance of HFOs was significantly related with the improvement of IQ,otherwise that of ESES did not show such correlation.Conclusion1.MPSL-P is an effective and safe therapy to treat CSWS.The improvement of cognitive function on children with CSWS is related to the control of epilepsy.2.HFOs can be used to predict the seizure relapse CSWS post MPSL-P therapy.HFOs can be used as a biomarker to predict the long-term effect and poor prognosis of CSWS.