目的探讨睡眠中癫痫性电持续状态(electrical status epilepticus during sleep,ESES)的脑电诊断及临床治疗。方法脑电图棘慢波指数(SWI)≥50%并完成治疗的癫痫患儿30例(A组16例:50%≤SWI<85%;B组14例:SWI≥85%),按就诊顺序随机分为C、D 2组,每组15例,行不同疗程(C组6个月,D组12个月)激素治疗,治疗前后均进行神经心理损伤评估,并随访治疗后的疗效及不良反应。结果 A、B 2组治疗前均有程度不一的神经心理损伤,言语智商(VIQ)、操作智商(PIQ)及总智商(FIQ)均较正常值低,以VIQ下降最显著,B组VIQ和FIQ较A组低,差异有统计学意义(P<0.05);C、D组VIQ、FIQ较激素治疗前均有增高(P<0.05),其中ESES消失者VIQ、FIQ明显高于治疗前(P<0.05),但C、D 2组间神经心理损伤改善程度及总有效率比较差异无统计学意义(P>0.05);D组不良反应大于C组(P<0.05)。结论 SWI≥50%定为ESES的脑电诊断标准有助于ESES的合理诊断,早期干预;激素治疗ESES安全有效,疗程6个月更合理。 Objective To investigate the EEG diagnosis and clinical treatment of electrical status epilepticus during sleep (ESES). Methods Thirty children with epilepsy (≥50% SWI) were enrolled in this study. Eighteen children with epilepsy were enrolled in this study (group A, 16 cases; 50% ≤SWI <85%; group B, 14 cases: SWI≥85% The patients were randomly divided into C and D 2 groups, with 15 cases in each group. Hormone therapy of different courses (C group, 6 months, D group, 12 months) were performed. Neuropsychological impairment was evaluated before and after treatment and follow- Adverse reactions. Results Group A and group B had neuropsychological impairment with different degrees before treatment. The scores of VIQ, PIQ and FIQ were lower than the normal values, and the most significant ones were VIQ. In group B, VIQ (P <0.05). The levels of VIQ and FIQ in group C and group D were significantly higher than those before hormone treatment (P <0.05), and the levels of VIQ and FIQ in those with ESES disappeared were significantly higher than those before treatment (P <0.05). However, there was no significant difference between the two groups in the improvement of neuropsychological impairment and in the total effective rate (P> 0.05). The adverse reaction in group D was more than that in group C (P <0.05). Conclusion SWI ≥ 50% as ESES diagnostic criteria for ESEG contribute to the rational diagnosis of ESES, early intervention; hormone therapy ESES safe and effective treatment of 6 months more reasonable.