The Study Of The Characteristics Of Sleep Disorders In Benign Childhood Epilepsy With Centrotemporal Spikes

ObjectiveResearch Benign childhood epilepsywith centrotemporal spikes(BECT)is a common epileptic syndrome in childhood.Normal sleep has been used as the diagnostic criterion of BECT.With the further study,more and more questions have been queried about the so-called "benign" of BECT in recent years.The sleep characteristics ofBECTand the sleep-related neuropsychological function scale were evaluated by polysomnography and clinical scale.Method1 Participants: From June 2016 to June 2018,25 children of BECTwere selected from the neurology outpatient clinic of Tianjin Children’s Hospital according to the classification of epilepsy syndrome established by the ILAE in 1989.At the same time,15 healthy controls were recruited.2.Collecting history,BECT patients had no epileptic seizures from March to the day before polysomnography.3.Polysomnography was performed in 25 patients with BECT and 15 healthy controls.The parameters of polysomnography included sleep structure parameters,respiratory events,limb movement and percutaneous oxygen saturation.All parameters were analyzed and compared with SPSS 18.0 software system.Since the relevant parameters conform to normal distribution,t test analysis is used.4.The sleep-related neuropsychological function was assessed by the Wechsler Child Intelligence Scale(WISC-R)and Continuous Execution Test(IVA-CPT)in 25 patients with BECT and 15 healthy controls.5.SPSS18.0 software was used to analyze the correlation between objective sleep parameters,clinical features and neurological function scale scores in BECT patients.Result1.The results of polysomnography showed that the ratio of REM phase(% TST)in BECT group was lower than that in healthy control group(13.5% vs 19.5%,P = 0.044),and there was no difference in other sleep structure parameters.There was no difference in the proportion of abnormal apnea-hypopnea index and so on.2.The results of clinical scale evaluation showed that there was no difference in FIQ 、VIQ and PIQ.Continuous Execution Test Function Scale: Compared with the healthy control group,the comprehensive attention quotient the visual attentionquotient decreased and the auditory attention quotient all decreased.3.The polysomnography results showed that there was no difference in sleep indices between the BECT subgroups and the healthy control group.The WASOwas prolonged and the REM(% TST)ratio was decreased in the non-discharging subgroup,while the WASO was prolonged in the discharging subgroup.The TIB was prolonged,the WASO was prolonged,the SE was decreased,and the REM(% TST)ratio was decreased in BECT patients compared with non-discharge subgroup.Less compared with group 0,there was no difference in sleep indices between subgroups with discharging index less than 20%;REM(% TST)ratiodecreased in subgroups with discharging index less than 20%.WASO prolonged after falling asleep;discharging index 20-40% in patients with BECT.The ratio of REM(% TST)was lower in subgroup than in subgroup with discharge index less than 20%.Compared with the healthy control group,there was no difference in sleep indices between oral oxcarbazepine group and BECT group;REM(% TST)was decreased in oral levetiracetam group;sleep indices in oral levetiracetam group and oral oxcarbazepine group were significantly lower than those in oral oxcarbazepine group.WASOprolonged and the REM(% TST)ratio decreased.Compared with healthy controls,there was no difference in sleep indices among subgroups with a course of more than 2 years;REM(% TST)was decreased in subgroups with a course of less than 2 years;and SE was observed in subgroups with a course of more than 2 years.AndWASO prolonged.4.The results of clinical scale evaluation showed that the VIQ score of the discharged subgroup was significantly lower than that of the non-discharged subgroupFIQ score was no difference,PIQ score was no difference.Compared with the non-discharging subgroup,the auditory arousal quotient decreased,the visual arousal quotient decreased,the comprehensive attention quotient had no difference,and the visual attention quotient had no difference.There was no difference in attention quotient,and no difference in visual speed quotient.There is no difference in auditory speed quotient.5.Correlation analysis showed that the percentage of REM(% TST)in BECT patients was negatively correlated with the discharge index,but was not correlated with the duration of the disease;the wake-up time after falling asleep was negatively correlated with the duration of the disease and positively correlated with the discharge index;the speech intelligence quotient of BECT patients was not correlated with the percentage of REM(% TST)and negatively correlated with the wake-up time after falling asleep.The ratio of REM(% TST)in BECT patients was positively correlated with the course of disease,and negatively correlated with SWI;theWASO after falling asleep was negatively correlated with the course of disease.Negatively correlated with SWI;WASO after falling asleep was not correlated with REM(% TST)ratio;SWI was negatively correlated with disease duration.VIQ was not correlated with REM(% TST)ratio,but was negatively correlated withWASO after falling asleep.The ratio of REM(% TST)to VIQ was not correlated withWASOafter falling asleep.Conclusion1.Compared with healthy controls,the proportion of REM(%TST)in polysomnography sleep in BECT patients decreased.BECT patients were divided into subgroups according to discharge,course of disease and medication.The main sleep disorders of BECT patients were decreased REM(% TST)and prolonged WASO after falling asleep.2.Compared with healthy controls,BECT patients had lower VIQ scores in the discharge subgroup.Compared with healthy controls,the attention quotient of audio-visual execution in BECT patients was generally reduced.3.The REM(% TST)ratio in BECT patients was negatively correlated with REM(% TST)and was not correlated with the duration of the disease;theWASO was negatively correlated with the duration of the disease and positively correlated with SWI;theVIQ was not correlated with the REM(% TST)ratio in BECT patients,but negatively correlated with the WASO.Awareness quotient of BECT patients was positively correlated with VIQ,course of disease,negatively correlated with SWI,and was not correlated with REM(% TST)ratio and WASO.