Curative Effect Analysis Of Different Treatments In Bect With Electrical Status Epilepticus During Sleep

Objective:To analyze the efficacy and tolerance of different treatments in benign childhood epilepsy with centro-temporal spikes(BECT)with electrical status epilepticus during sleep(ESES).Methods:The data of 77 patients of seizure uncontrolled in BECT with ESES in the first affiliated hospital of guangxi medical university from november 2015 to september 2018 were collected.A retrospective analysis was operated for them.According to different treatments,patients were divided into:(1)Based on whether or not methylprednisolone was used after the onset of ESES,the following were classified as:anti-epileptic drugs(AEDs)+methylprednisolone group(N=31)and only AEDs group(N=46);(2)Based on the course of methylprednisolone,the following were classified as:one course group(N=24)and two courses group(N=7);(3)In the only AEDs group,patients who treated with clonazepam(CZP)(N=9)were compared before and after treatment.Taking six months after treatment as the evaluation point,to analyze the of efficacy for epileptic seizure and ESES phenomena of electroencephalogram,the relationship between the ESES and epileptic seizure,the incidence of adverse drug reactions of different treatments;estimatedthe factors affecting neuropsychological function in BECT after the appearance of ESES.Results: 1.At six months after treatment,the total effective rate of seizure in AEDs + methylprednisolone group was higher than the only AEDs group(P=0.049);there was no significant difference in the total effective rate of seizures in one course group and two courses group(P>0.05);in the only AEDs group,the seizure was significantly improved than before in patients who treated with CZP,and the total effective rate was 88.9%(8/9).2.At six months after treatment,the ESES improvement rate in AEDs +methylprednisolone group was higher than the only AEDs group(P=0.039);there was no significant difference in the ESES improvement rate of one course group and two courses group(P>0.05);in the only AEDs group,the ESES was significantly improved than before in patients who treated with CZP,and the ESES improvement rate was 77.8%(7/9).3.At six months after treatment,the seizure control rate in patients with improved of ESES was higher than patients without improvement of ESES(P=0.036).4.The incidence of adverse drug reactions in AEDs + methylprednisolone group was higher than the only AEDs group(P=0.022);there was no significant difference in the incidence of adverse drug reactions of one course group and two courses group(P>0.05);in the only AEDs group,the incidence of adverse drug reactions was 33.3%(3/9)in patients who treated with CZP.5.The age of first monitoring ESES less than seven years and the efficacy of ESES without improved,neuropsychological impairment were more likely to occur(both P<0.05).Conclusion: 1.The efficacy of AEDs combined with methylprednisoloneon epileptic seizures and ESES phenomena of electroencephalogram in BECT with ESES patients was better than AEDs alone,the incidence of adverse drug reactions in the former was higher than the latter,both of them were tolerable.2.The addition of CZP was effective in the improvement of epileptic seizures and ESES phenomena of electroencephalogram in BECT with ESES patients.3.The more obvious the improvement in ESES phenomena of electroencephalogram,the greater the possibility of seizure control.