The Clinical Analysis On Variants Of Benign Childhood Epilepsy With Centrotemporal Spikes

Objective: To explore the atypical clinical symptom, electroencephalographic(EEG) features,treatment strategies and outcome in a series of children with variants of benign childhood epilepsy with centrotemporal spikes(BECT).Methods: We collected 51 cases that children who were diagnosed with BECT in Epilepsy Medical Center of Liaoning Province which is also known as Epilepsy Medical Center of the Sencond Hospital of Dalian Medcial University(from July 2010 to February 2015). Out of them, 36 cases were diagnosed with typical BECT(typical group), 15 cases were identified as BECT vatiants(atypical group). The Chi-Square analysis and t-test were used to find out wheather there is ststistically significant on the sex or onset age of two groups or not.All cases of atypical group underwent4hours-VEEG, neuroimaging(MRI/CT) to make good assessments of seizures and choose proper antiepileptic drugs(AEDs).With a long-term follow-up, their progesses were recorded. We analyzed the characteristic clinical-electrophysiology, response to AEDs and outcome of BECT vatiants.Results:1. There’s no ststistically significance on sex between the typical and atypical group. Children of the atypical group had earlier onset age, and there was ststistically significance.2. The main changes of atypical group as followed: multiple episodes and worse response to AEDs; vatiants of type ? including ENM and AA, type ?? including salivation and speech disorders,or both symptom of the two; worse EEG, ESES andeven special waves which represent ENM or AA. The onset of the atypical seizures may coincide with hyperactivity, vandalism, reaction de?cit, learn disability.3. Till last follow-up, with AEDs 9 cases had no seizures that markedly effective, 2cases effective, 2 cases poor effective and 2 cases ineffective; 1 case had normal EEG, 9cases had improvment on EEG, and the other 5 had no obvious improvment on EEG.Conclusions:1.Among chinldren who were diagnosed with BECT, those have an earlier age of onset, more frequent and prolonged focal seizures than classic forms would be more likely to evolve into BECTS variants, which occouring type ?、type ?? or both symptom of the two, more frequent focal seizures, or ESES, special waves which represent ENM or AA.. Majority of them have favourable response to AEDs, that means seizures have ceased, IEDs partily disappear. However, the complete disappearance of IEDs need at least 3-5 years or even longer treatment.2. We learned that they have a favourable response to LEV and/or VPA. Individual treatment strategy is significant. The outcomes depend on earier standard treatment,seizure type and any other factors. Since the limit of cases and follow-up period,long-term assessment will be better.3. Opportune follow-up is necessary for children with BECT. In case atypical factor occurred, EEG should be re-assessed, what’s more important, treatment ought to remade. Earlier standard treatment will be likely to a better outcome.