Study On Cognitive Function Of Children With Benign Epilepsy With Centrotemporal Spikes Before And After Treatment

Objective(s):Benign childhood epilepsy with centrotemporal spikes(BECTs)is a common clinical childhood epilepsy syndrome,which has typical EEG characteristics,age dependence and good treatment effect on AEDs.For a long time,it has been considered that there is no mental retardation in children with BECT,but in the past 20 years,with the development of professional neuropsychological testing tools,the brain electrophysiology and event-related potentials,it has found that the cognitive function of children with BECT was lower than that of normal children of the same age.The purpose of this study is to uncover whether there is cognitive impairment in children with BECT compared with healthy children,and the changes of cognitive function after treatment,also to evaluate the correlation between intelligence level and seizure times and discharge index according to the characteristics of EEG,so as to explore whether there is cognitive impairment in children with BECT and its related factors.Methods:From September 1,2018 to December 31,2019,30 children with benign epilepsy in the pediatric neurological disease clinic of the first affiliated Hospital of Kunming Medical University were diagnosed as benign epilepsy with spikes in the central temporal region,and 30 children who were followed up for more than one year were divided into BECT group(affected group)according to the doctor’s instructions.The contents of follow-up included the condition of clinical seizures before treatment,6 months and 12 months after treatment,the results of EEG reexamination,the score of Wechsler Intelligence scale for Children.All the children were treated with single drug;at the same time,30 healthy volunteer children matched with their sex,age and education level were selected(control group),and the children and parents of the two groups had informed consent,were willing to participate in the study and had a good willingness to cooperate.All the data were summarized and statistically analyzed by SPSS22.0.The measurement data were expressed by mean±standard deviation in normal distribution and quartile in non-normal distribution.Independent sample t-test was used in pre-treatment,6-month,12-month treatment and healthy children.Paired sample t test was used to evaluate the cognition of children before treatment,6 months and 12 months after treatment.Spearman rank correlation analysis was used to explore the correlation between various factors and cognitive level,and the effect of medication on cognition was analyzed by single factor analysis of variance(ANOVA).P<0.05 indicates that there is statistical difference.Results:1.In 30 children with BECT,the average results of WICS,6 months and 12 months after treatment were lower than those in the healthy control group,but in the normal range,the scores of FIQ and VIQ before treatment were lower than those in the healthy control group,and the difference was statistically significant,indicating that the verbal IQ of children with BECT was impaired to some extent.2.In 30 children with BECT,the results of WICS,6 months and 12 months after treatment showed that FIQ,VIQ and PIQ were all in the normal range.After 6 and 12 months treatment,the scores of VIQ,PIQ and FIQ were significantly higher than those before treatment,that is,the cognitive function was significantly improved.3.In 30 children with BECT,after 12 months of AEDs treatment,the discharge index and the number of seizures were significantly decreased compared with those before treatment.Before treatment,the correlation between discharge index and Full-scale intelligence quotient(FIQ)was negatively correlated,indicating that the higher the discharge index,the more significant the cognitive impairment.There was no correlation between the number of seizures and FIQ.4.There was no statistic difference in the effects of LEV,VPA and OXC on the cognitive function of children with BECT.Conclusion(s):Cognitive impairment exists in children with BECT,mainly verbal intelligence quotient and total intelligence quotient.The AEDs in children with BECT has a good effect,which can reduce the number of seizures and epileptiform discharge of EEG,and the cognitive function can be improved after regular treatment.The discharge index of EEG in children with BECT is negatively correlated with FIQ,that is,the higher the discharge index,the more impairment of cognition.There was no significant difference in the effects of OXC、VPA and LEV on the cognitive function of children with BECT.