Research Of EEG Epileptiforn Discharges, Sleep Spindle Waves And Sleep Construction In BECT Patients

Objective: Benign childhood epilepsy with centro-temporal spikes (BECT) childhood, one of the most common epilepsy syndrome, Also known as benign rolandic epilepsy (benige rolandic epilepsy),About 20% of epilepsy in children, the incidence age of 2 to 14 years of age, to 5 to 10 years as more common. BECT of primary partial epilepsy, the cause is unclear, there may be genetic predisposition, and is closely related with sleep,and has a special attack symptoms. EEG showed the central area and the temporal limitations of discharge, 24-hour ambulatory EEG is a brain-cell function in the most direct reflection.Changes in sleep EEG can be analyzed to detect changes in sleep, the indicators, as well as epileptiform discharges impact on disease diagnosis, classification and guide treatment have a high application value. In 1953, Aserinsky, etc., while EEG recorded in the record to the eye movement, found a rapid eye movement sleep (REM), So it promotes multi-channel monitoring of sleep and technological development, with the development of sleep detection technology, also with EEG, eye movements and electromyographic manifestations ,sleep is divided into two pairs of non-rapid eye movement sleep (NREM) and rapid eye movement sleep (REM ). Sleep spindles in human normal light sleep period (non-rapid eye movement NREM) characteristic graphics, full-term children with 3 months all can be seen sleep spindles in the baby sleep recording light. If the sleep cycle (in a light sleep )during the entire 10 mim or more consecutive record still do not see sleep spindles ,it shall be considered an exception, Sleep disturbance as a potential influencing factors, in recent years, attracted people's attention. Dynamic EEG is value of BECT the diagnosis and differential diagnosis . and these have been affirmed by many researchers, especially the night natural sleep EEG in the diagnosis and analysis of BECT patient's sleep cycle, sleep construction changes has the unique application value. BECT the existence of sleep disorders in children, its epileptiform discharges on whether the impact of sleep architecture in children and whether children with sleep quality can lead to reduced learning ability is reduced, in recent years has attracted clinical attention.With the EEG technology development, the relationship between the BECT and sleep research has gradually developed depthly and make some new understanding. But researches of EEG epileptiforn discharges, sleep spindle waves and sleep construction in BECT patients are rarely, the purpose of this study is to discusses relations between epileptiforn discharges, sleep spindle waves and sleep construction in 24 hour dynamic electroencephalogram with BECT patients, so we can have more understanding to the young child benign epilepsy.Method: 1 object of study Chooses the BECT epilepsy patient 30 examples who were the first time diagnosised in my courtyard nerve group seeing a doctor from March, 2008 to December, 2009 , the age approximately between 5-10 years old, the boy occupies 20 examples, the girl occupies 10 examples, Male to female ratio was 2.0:1, Age 3-13 years old, with an average age of 7.96±4.32 years old, 3-5 year-old in 5 cases, 5-7-year-old in 13 cases ,7-10-year-old in seven cases ,10-13 years old in 5 cases, the course was the minist 3 days and the longest two years, Control group, 10 cases, 6 cases of boys, girls accounted for 4 cases, aged 2-10 years old, with an average age of 5.94±3.21 years old.2 Methods:2.1 Nation8128 made in shanghai company of nuocheng ambulatory EEG instrument and its matching of dynamic EEG analysis system were used, According to the international 10 / 20 system,we placed 16 scalp electrodes and used fire cap cotton elastic to fix adhesive nature , leaded to connect flight recorder boxes with 24h real-time record, and told pations and family to detail records time of activities. Monitoring process, the patient's conscious turned a blind eye five times, each time 20min, to inquiry, no hyperventilation in patients with contraindications to do four times hyperventilation, every 3min. Removed the records after the end of 24h recording box, entered the host, took the time constant of 0.3, filtered of 50Hz, real-time record of 50 speed playback analysis, in which the natural sleep at night with 20-speed analysis, observed of epileptic-like discharge, sleep spindle hammer wave sleep phase change duration.2.2 The normal sleep is NREM sleep and REM sleep, two different phase composition of sleep. NREM sleep is divided into 1, 2, 3, 4, NREM sleep three and four collectively known as slow-wave sleep (SWS). REM sleep, also known as the fast wave sleep. Non-rapid eye movement sleep (NREM) EEG characteristics in accordance with man-made would be divided into four: brain waves withθwave (frequency of 8 ~ 13 times / S, amplitude 10 ~ 100V)-based, did not appeared spindle waves or K-F wave complex as stageⅠ, brain waves appeared spindle wave (frequency of 12-14 times / S) and K-F wave complex and theδ-wave (frequency of 0.5 ~ 3 times / S, volatility generally 100μV or so) less than 20 % in stageⅡ, brainδ-wave waves accounted for 20% to 50% of stage isⅢ;, brain waves for more than 50% ofδ-wave, part of deep sleep knewn as stageⅣ. Throughout the course of sleep, NREM sleep and REM sleep were alternating. Quantitative analysis of a 24-hour EEG sleep cycles of the number of epileptic discharge, as well as changes in sleep spindles in various sleep cycles (NREMⅠ,Ⅱ,Ⅲ,Ⅳ) on the percentage share of total sleep period.3 Statistical methods: data management and statistical analysis software processing through the SPSS11.5 statistical analysis, P<0.05 for the difference was significant, data measurement data using unpaired t test and linear correlation analysis method for analysis.Result;1 An EEG changes in sleep phase Epileptiform discharge occurred 30 cases, the epileptiform discharges in NREMⅠ~Ⅱperiod of up to (53.3%), and NREMⅢ~Ⅳ, REM, NREM - REM phase difference was highly significant (P﹤0. 01), see Table 12 Two groups at all time during sleep BECT the proportion of patients with significant changes in sleep architecture in order to light sleep phase (NREMⅠ~Ⅱperiod) the proportion of time allocated to the control group was significantly longer than that, deep sleep phase (NREMⅢ~Ⅳ) time (P﹤0.01), while the total sleep time and REM period of time, the proportion was no significant difference (P﹥0.05) Table 2;3 Comparison of two groups of sleep spindle waves of sleep EEG in 30 cases of BECT observed in patients with bilateral asymmetric spindles in 6 cases (20.0%), all for some paroxysmal patients, bilateral spindles observed reduced or disappear 10 cases (33.3%). The control group was not observed reduction in sleep spindles, disappear or asymmetries.4 the relationship of epileptiform discharges and sleep spindles: between the 30 cases of BECT ,sleep EEG epileptiform discharges were monitored frequency of 658 times ,the number of epileptiform discharges and sleep spindles negatively correlated (r =- 0.625, P﹤0.05). Epileptiform discharge frequency and the relationship between sleep spindles Table 3Conclusion: 1 The discharge of BECT pations are more in NREMⅠ～Ⅱperiod.2 The sleep structure has obviously changed in BECT, NREMⅠ～Ⅱperiod of time is longer than NREMⅢ～Ⅳperiod in sleep duration.3 BECT pations are likely to see the spindle waves away or asymmetrical.4 Sleep obstacles existing in BECT pations might lead to reduce sleep quality, or even may learning ability.