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目的探讨卡马西平联合盐酸哌甲酯控释片治疗小儿良性癫痫(benign epilepsy with centro-temporal spikes.BECTS)伴中央颞区棘波合并注意缺陷多动障碍(attention deficit hyperactivity disorder.ADHD)的临床疗效。方法选择2011年1月至2016年1月于本院精神内科治疗且确诊BECTS伴ADHD的患儿80例作为研究对象,首先采用卡马西平单药治疗,若6个月内复查脑电图稳定,联用盐酸哌甲酯控释片进行继续治疗。观察盐酸哌甲酯控释片治疗前后患儿注意力和行为改善情况、癫痫发作情况、不良反应和治疗效果。结果卡马西平治疗3个月后有效的56例患儿联合盐酸哌甲酯治疗6个月治疗后,ADHD治疗总有效率为92.73%(51/55),且与联合治疗前相比,Conner儿童行为的问卷评分显著降低。1例(1.82%)患儿在治疗2个月后癫痫发作频率和EEG异常放电频率增加,停药后即未发作,停药4周后再服药,未再出现癫痫发作增加现象。结论卡马西平联用盐酸哌甲酯控释片能够有效的控制BECTS伴ADHD患儿的临床症状,明显改善患儿的注意力及其社会功能,且具有一定的临床安全性。
Objective To investigate the clinical efficacy of carbamazepine combined with methylphenidate controlled release tablets in the treatment of benign epilepsy with centro-temporal spikes.BECTS with central temporal spikes and attention deficit hyperactivity disorder (ADHD) Efficacy. Methods From January 2011 to January 2016 in our hospital psychiatric treatment and diagnosis of BECTS with ADHD in 80 cases of children as the research object, the first use of carbamazepine monotherapy, if within 6 months review EEG stable , Combined with methylphenidate controlled release tablets for further treatment. Observation of methylphenidate controlled-release tablets before and after treatment in children with attention and behavior improvement, seizures, adverse reactions and treatment. Results After 56 months of carbamazepine treatment effective 56 cases of children combined with methylphenidate hydrochloride treatment 6 months after treatment, the total effective rate of ADHD treatment was 92.73% (51/55), and compared with before treatment, Conner Child behavior questionnaire scores significantly reduced. The frequency of epileptic seizures and the frequency of abnormal EEG discharge increased in 1 patient (1.82%) two months after treatment, and no seizures occurred after discontinuation of treatment. After 4 weeks of withdrawal, the seizure no longer occurred in seizures. Conclusion Carbamazepine combined with methylphenidate controlled-release tablets can effectively control the clinical symptoms of children with BECTS accompanied by ADHD, significantly improve children’s attention and social function, and has a certain clinical safety.