Abstract: Objective To study the relationship between the incidences of electrical status epilepticus during sleep (ESES) and attention deficit and hyperactivity behaviors (like-ADHD) and to investigate whether the two diseases were independent diseases or the brain damage caused by ESES is the basis of attention deficit and hyperactivity behavior. Methods The children diagnosed as benign childhood epilepsy with central-temporal spikes (BECT) variant with ESES (A group) and BECT (B group) were collected from the children's neurological clinic.The incidence of attention deficit and hyperactivity behaviors in each group,and the difference of Conners parents' questionnaire were compared.The children in A group were treated with standard hormone therapy and re-evaluated attention deficit and hyperactivity morbidity before and after treatment,and the 6 factor scores in Conners parents' questionnaire were compared by paired t test before and after treatment. Results In the group A,28 cases were detected,18 cases were diagnosed with attention deficit and hyperactivity behaviors,the positive rate was 64.3%.In the group B,26 were detected and 7 cases were with attention deficit and hyperactivity behaviors,the positive rate was 26.9%.The incidence of those behaviors in the A group was significantly higher than that in the B group (P=0.038).In the group A,the factor scores such as the learning problem,psychosomatic disorder,hyperactivity and hyperactivity index in Conners parents' questionnaire were significantly higher than those of the B group.28 cases in A group were completed a total of 6 months of hormone therapy.Seizure or seizures decreased more than 50% and ESES disappeared 3~6 months (discharge index lower than 30%) in 17 case patients.The Conners parent questionnaire was performed in 17 patients with ESES,diagnosed with attention deficit and hyperactivity behaviors were 5 cases,and the positive rate was 29.4%.Compared with pre-treatment,detection rate was significantly lower (P=0.023).After the disappearance of ESES,the score of the factors such as learning problem,impulse hyperactivity and a lot of moving index scores decreased significantly. Conclusion The children with attention deficit and hyperactivity and other symptoms were associated with brain dysfunction.ESES phenomenon can lead to brain advanced neurological impairment,and is the basis for the high prevalence of epilepsy combined with attention deficit and hyperactivity behaviors.

Key words: electrical status epilepticus during sleep, benign childhood epilepsy with central-temporal spikes, attention deficit and hyperactivity behavior, Conners Questionnaire, glucocorticoid

摘要： 目的 研究睡眠中癫痫性电持续状态(ESES)与注意力缺陷多动行为发病的关系，探讨两者是独立的共患病，还是ESES导致的脑功能损伤是注意力缺陷多动行为发病的基础。方法 收集小儿神经门诊诊断为伴ESES的伴中央颞区棘波的小儿良性癫痫(BECT)变异型患儿(A组)以及单纯BECT患儿(B组)。比较注意力缺陷多动障碍(ADHD)水平行为在各组的发病率，以及Conners父母问卷各因子评分的差异。A组患儿予以激素标准治疗后，再次评估类ADHD水平行为发病率在治疗前后的差异，同时用配对t检验比较治疗前后Conners问卷6类因子的评分差异。结果 A组共28例患儿，检出ADHD水平行为患儿18例，检出率64.3%，B组26例检出ADHD水平行为7例，检出率为26.9%。ADHD水平行为在A组发病率明显较B组高(P=0.038)。A组患儿在学习问题、心身障碍、冲动多动及多动指数等因子方面得分明显较B组患儿高。A组患儿共28例，予以共6月的激素疗程完成后，发作控制或发作减少50%以上，同时ESES消失(放电指数<30%)3~6个月的患儿，共17例。A组17例治疗有效的患儿再次行Conners父母问卷，ADHD水平行为阳性检出5例，检出率为29.4%，较治疗前检出率明显降低(P=0.023)。ESES消失后，患儿学习问题、冲动-多动及多动指数等因子得分明显降低。结论 伴ESES的BECT患儿易出现注意力不集中、多动冲动等表现，与ESES现象导致高级神经功能受损有关。

关键词: 睡眠中癫痫性电持续状态, 伴中央颞区棘波的儿童良性癫痫, 儿童注意力缺陷多动行为, Conners问卷, 糖皮质激素