■本研究旨在评估大剂量皮质类固醇治疗在诊断为癫痫性脑病并伴有睡眠中的尖峰波激活（EE-SWAS）的儿童中的疗效。调查影响治疗结果的相关临床指标，并建立复发的预测模型。
■被诊断为EE-SWAS且接受大剂量皮质类固醇治疗的儿童被分为应答组和非应答组。关于临床参数的数据，脑电图（EEG）特征，收集血清细胞因子水平。治疗后六个月,将得到有效治疗的儿童进一步分为复发组和非复发组.使用单变量分析确定皮质类固醇治疗后不良预后的危险因素。多因素logistic回归分析确定影响激素治疗复发的独立因素。这促进了预测模型的发展。
■这项研究包括48名儿童，应答者组33例(有效率=68.8%)，无应答者组15例。响应者组表现出睡眠电持续状态（ESES）的发病年龄更大，使用苯二氮卓类药物（BZD）的比例更高（P<0.05）。在那些对皮质类固醇治疗有反应的人中，11例复发（复发率=33.3％），22例没有。两组之间在癫痫发作年龄方面观察到显着差异。ESES发病年龄，癫痫发作频率,非典型演示文稿，并伴随额叶放电（均P<0.05）。合并额叶放电和癫痫发作年龄较早被确定为皮质类固醇治疗后ESES复发的危险因素。预测模型为Logit（P）=2.35×额叶放电的存在-0.802×癫痫发作年龄2.457。受试者工作特征曲线下面积(AUC)为0.93,敏感性和特异性分别为100%和77.3%,分别。
■大剂量皮质类固醇治疗EE-SWAS具有很高的有效率和明显的复发率。ESES的发病年龄和苯二氮卓类药物的联合使用与治疗效果相关。癫痫发作年龄和额叶放电的存在可能对皮质类固醇治疗后复发具有预测价值。
UNASSIGNED: This study aims to evaluate the therapeutic efficacy of high-dose corticosteroid therapy in children diagnosed with epileptic encephalopathy with spike-and-wave activation in sleep (EE-SWAS), investigate associated clinical indicators influencing treatment outcomes, and establish a predictive model for recurrence.
UNASSIGNED: Children diagnosed with EE-SWAS who received high-dose corticosteroid therapy were categorized into responder group and non-responder group. Data on clinical parameters, electroencephalogram (EEG) features, and serum cytokine levels were collected. Six months post-treatment, the effectively treated children were further stratified into recurrence and non-recurrence groups. Risk factors for poor outcomes following corticosteroid therapy were identified using univariate analysis. Multivariate logistic regression analysis was then employed to determine independent factors influencing the recurrence of corticosteroid therapy, which facilitated the development of a predictive model.
UNASSIGNED: The study included 48 children, with 33 cases in the responder group (effective rate = 68.8%) and 15 cases in the non-responder group. The responder group exhibited an older onset age of electrical status epilepticus in sleep (ESES) and higher proportions of combined benzodiazepines (BZDs) use (P < 0.05). Among those responding to corticosteroid therapy, 11 cases experienced a recurrence (recurrence rate = 33.3%), while 22 cases did not. Significant differences were observed between the two groups concerning age of seizure onset, age of ESES onset, seizure frequency, atypical presentations, and concomitant frontal lobe discharges (all P < 0.05). Concomitant frontal lobe discharges and an earlier age of seizure onset were identified as risk factors for ESES recurrence following corticosteroid therapy. The predictive model was formulated as Logit(P) = 2.35 × presence of frontal lobe discharges-0.802 × age of seizure onset + 2.457. The Area Under the Curve (AUC) of Receiver Operating Characteristics (ROC) was 0.93, with sensitivity and specificity at 100% and 77.3%, respectively.
UNASSIGNED: High-dose corticosteroid therapy for EE-SWAS exhibited a high effective rate as well as a notable recurrence rate. Onset age of ESES and combined benzodiazepines usage correlated with therapeutic efficacy. Seizure onset age and the presence of frontal lobe discharges may hold predictive value for recurrence following corticosteroid therapy.
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