| Objective: To explore the efficacy of different initial anti-seizure medications(ASMs)in patients with self-limited epilepsy with centrotemporal spikes(Se LECTS)and the cognitive impairment in patients with Se LECTS combined with ESES.By comparing the clinical data,EEG and follow-up results of patients,we explored the curative effect of different ASMs on Se LECTS patients,helped Se LECTS early drug selection and systematic management,and reduced the occurrence of adverse outcomes.Methods: A retrospective analysis of 224 Se LECTS patients who were treated in the Department of Pediatrics and Neurology of the Affiliated Hospital of Jining Medical University from January 2017 to January 2021,196 of them chose drug treatment,and patients were divided into three groups according to the initial treatment drugs: levetiracetam group(n=102),valproate group(n=76)and oxcarbazepine group(n=18),the seizure form,seizure frequency and EEG were recorded.The choice of treatment drugs,the efficacy of epileptic seizures and the degree of remission of ESES in patients in different groups were analyzed.The Wechsler Intelligence Scale for Children(WISC-IV)was used to evaluate the cognitive function structure and distribution characteristics ofSe LECTS patients.A total of 72 patients were collected and divided into the combined typical ESES group according to whether they were combined with ESES and the SWI value of ESES,combined with atypical ESES group,typical ESES group and Se LECTS group;Children’s Sleep Habits Questionnaire(CSHQ)was used to evaluate the occurrence of sleep problems in Se LECTS patients.A total of 143 patients were collected and divided into combined ESES group and Se LECTS group according to whether ESES was combined.Results:This study showed that 194/224 Se LECTS patients received ASMs treatment,among which 147 patients had a decrease in seizure frequency after initial monotherapy,and three ASMs of levetiracetam,valproate,and oxcarbazepine were used as initial treatment,There was no statistical difference in the initial Monotherapy failure rate,seizure control rate,and ESES remission rate,and there was no statistical difference in the seizure control rate when the above three drugs were used as additional drugs.Compared with the ASMs group,ASMs combined with benzodiazepines can effectively relieve ESES,and the difference is statistically significant.At the same time,it was found that the seizure control rate of ESES remission patients was higher than that seizure control rate of ESES non-remission,which was statistically significant.72 patients completed the WISC-Ⅳ,and found that the combined typical ESES group,the combined atypical ESES group andthe Se LECTS group had statistically significant differences in all dimensions and total scores,and the typical ESES group had the lowest score,followed by the atypical ESES group;the Se LECTS group had the highest score.143 patients completed the Children’s Sleep Questionnaire(CSHQ).The incidence of sleep problems in the multi-therapy group was 27.8%,which was higher than that in the monotherapy group(13.08%).The total score of children’s sleep habits questionnaire and the scores of parasomnia and daytime sleepiness in the ESES group were higher than those in the Se LECTS group,and the difference was statistically significant.Conclusion: Monotherapy can control seizures in most Se LECTS patients,and levetiracetam,valproate,or oxcarbazepine were all effective in reducing seizure frequency when initial monotherapy was chosen.Benzodiazepines can effectively relieve ESES on the basis of ASMs.The degree of cognitive impairment was more serious in patients with ESES than in patients with Se LECTS.Se LECTS patients have significant impairments in speech comprehension,perceptual reasoning,working memory,and processing speed.Most Se LECTS patients with ESES have sleep problems,and the parasomnias and daytime sleepiness are higher than those of Se LECTS patients. |
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