Efifcacy Of Methylprednisolone Therapy On Electrical Status Epilepticus During Slow Sleep In Children

Objective：electrical status epilepticus during the sleep (ESES), is a unique electricalphenomena in children, refers to nearly continuous localized or generalized spikewave in the slow wave sleep in patients, and usually take the wave index (SWI)≥50%as the standard. Although only0.5%of children with epilepsy has ESES, but it isoften accompanied by neuropsychological damage, and even more prominent than theseizures. The focus of treatment is to eliminate the electrical status. Recent researchreports suggest that corticosteroid therapy is effective in the elimination of theelectrical status to improve the neuropsychological damage. ESES including severalkinds of epilepsy syndrome, most of them have severe psychomotor retardation. Inwhich The BECTS complicated with ESES has the best prognosis, easy to carry outthe cognitive aspects of the determination. We Selected60cases BECTS complicatedwith ESES, divided into the traditional anti-epileptic drugs treatment group andmethylprednisolone combined with traditional antiepileptic drug treatment group, toevaluate the clinical efficacy and cognitive effects of methylprednisolone treatment ofESES.Methods：60-cases BECTS complicated with ESES were randomly divided intotreatment and control groups. The treatment group were given methylprednisoloneequential therapy, during the same time maintain the original anti-epileptic drugstreatment. The control group were give sodium valproate, oxcarbazepine, topiramate,levetiracetam, lamotrigine triazine and other drug treatment according to theirindividual seizure types. Before and after treatment were recorded EEG, WechslerIntelligence Test, observe the onset of the control conditions and adverse drugreactions, comparative analysis of the efficacy of methylprednisolone pulse therapyresults. Results presented as mean±standard deviation, SPSS18.0statistical softwarefor statistical analysis between the two groups were compared using the t test. P <0.05was considered statistically significant. Results：①clinical efficacy of treatment group30cases,7cases of attack control,effective in20cases, ineffective in3cases, the total efficiency90.0%; the controlgroup30cases,6cases of attack control, effective in17cases, ineffective in7cases,the total efficiency76.7%. There was no significant difference between two groups.②EEG changes in the treatment group30cases, effective in25cases,ineffective in5cases, the efficiency of83.3%; in the control group (n=30), effectivein17cases, ineffective in13cases, the efficiency of56.7%; between the two groupsof EEG treatment efficiency by comparison, the difference was significant.③cognitive function in children4-6years and6-15years old children, thetwo groups, the treatment group and control group before the findings of differencesstatistically significant; treatment group medication before treatment and in6monthsfollow-up compared to VIQ, PIQ，FIQ were increased; compared with beforetreatment in the control group in6months follow-up VIQ, FIQ, PIQ has nosignificant difference;④adverse reactions can be caused by corticosteroids adverse reactions in thehormone therapy group, including infection, weight gain, hypokalemia. Whencorticosteroid diminished, the above adverse reactions disappear.23.3%of theadverse reaction rate of the treated groups;26.7%of the adverse reaction rate of thecontrol groups; Between2group, incidence of adverse reactions has no statisticallysignificant.Conclusions：①Methylprednisolone treatment of ESES has the similar efficiency in thecontrol in the clinical onset compared with single traditional antiepileptic drugs.②Methylprednisolone and traditional antiepileptic drugs treatment of ESEScan both alleviate the abnormal in EEG, although there has the possibility ofspontaneous remission, but methylprednisolone pulse therapy has more efficiency.③Methylprednisolone pulse therapy can alleviate the cognitive abilities ofchildren with ESES. But traditional antiepileptic drugs can not alleviate the cognitiveability in children.④Special adverse effects of methylprednisolone pulse therapy include infections, weight gain, but may disappear after treatment, compared to other adversereaction rate alone quite traditional antiepileptic drugs, no significant differences.