Abstract: Objective To summarize and analyze the clinical features and comorbidity of attention deficit and hyperactive disorder (ADHD) with self-limited epilepsy with centrotemporal spikes (SeLECTS) in children. Methods A total of 89 SeLECTS patients diagnosed in Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology from July 2020 to December 2022 were selected. The social demographic data, clinical manifestation, video electroencephalography (VEEG) results, treatment and prognosis of the children were collected. Swanson, Nolan and Pelham-Ⅳ Rating Scale (SNAP-Ⅳ) was used to assess the comorbidity of ADHD. Results 1) Clinical features:there were 49 males and 40 females in 89 cases of SeLECTS. The age of onset was 3- 12 years old, with an average of (7.22 ± 2.04) years old. The main seizure forms were motor seizures of focal origin (36 cases, 40.45%) and focal progression to bilateral tonic-clonic seizures (46 cases, 51.69%), and 7 cases (7.87%) had both. Main manifestations were unilateral clonic or tonic-clonic seizures, drooling, strabismus or upward movement of eyes, abnormal oral movement, and throat vocalization. 2) EEG characteristics:background activity of VEEG of 56 patients was normal, and epileptiform discharge waveforms were mainly sharp (spike) waves, sharp (spike) slow waves complex, spike clusters, and electrical status epilepticus during sleep (ESES). Spike wave index (SWI) during slow wave sleep was 33.00 (19.25, 53.25). 3) Treatment and prognosis:37 cases (41.57%) were seizure-free at least 6 months, and 23 cases (25.84%) were seizure-free at least 12 months. 4) Comorbidity:44 patients (49.44%) had comorbid ADHD. Compared with the non -ADHD group, the ADHD group had a younger age of onset (t=1.621, P=0.002), a higher SWI (Z=-2.134, P=0.038) and a higher incidence of ESES (χ²=4.308, P=0.038). Conclusions SeLECTS is a self -limited epilepsy syndrome in children with characteristic clinical and electroencephalographic features. For children with younger age, higher SWI and ESES, comorbid ADHD should be considered.

Key words: Epilepsy, Rolandic, Attention deficit disorder with hyperactivity, Comorbidity, Electroencephalography

摘要： 目的 总结伴中央颞区棘波的儿童自限性癫痫（SeLECTS）的临床特征及共病注意缺陷多动障碍（ADHD）情况。方法 纳入2020年7月至2022年12月华中科技大学同济医学院附属同济医院收治的89例SeLECTS患儿，收集社会人口学资料、临床表现、视频脑电图资料、治疗与预后资料，采用SNAP-Ⅳ量表判断是否存在注意缺陷多动障碍。结果 （1）临床特征：89例SeLECTS患儿男性49例，女性40例；首发年龄平均为（7.22 ± 2.04）岁。发作类型主要为局灶性运动性发作（36例，40.45%）和局灶性进展为双侧强直-阵挛发作（46例，51.69%），7例（7.87%）二者兼具。发作时主要表现为单侧阵挛或双侧强直-阵挛发作、流涎、双眼斜视或上翻、口角或下颌抽动、喉咙发声。（2）脑电图特征：56例患儿视频脑电图背景活动均正常，痫样放电波形主要为尖（棘）波、尖（棘）慢复合波、棘波簇，以及睡眠期癫痫性电持续状态；非快速眼动睡眠期棘波指数为33.00（19.25，53.25）。（3）治疗与预后：37例（41.57%）患儿控制至少6个月无发作，其中23例（25.84%）控制至少12个月无发作。（4）共病情况：44例（49.44%）共病注意缺陷多动障碍。与非ADHD组相比，ADHD组患儿首发年龄较小（t=1.621，P=0.002）、棘波指数（Z=-2.134，P=0.038）和癫痫性电持续状态发生率（χ²=4.308，P=0.038）较高。结论 SeLECTS是具有特征性临床和脑电图特征的儿童自限性癫痫综合征，对于年龄较小、棘波指数较高、存在睡眠期癫痫性电持续状态的患儿，应警惕共病注意缺陷多动障碍。

关键词: 癫痫, 罗兰多, 注意力缺陷障碍伴多动, 共病现象, 脑电描记术