Video-EEG在小儿发作性疾病中诊断价值的探讨  

Diagnostic value of video-EEG monitoring in children's seizures

作　　者：朱炳亮[1] 王纪文[2] 石秀玉[2] 孙若鹏[2] 郭庆辉[2] 郭淑华[2] 

机构地区：[1]山东省苍山县人民医院儿科,山东苍山277700 [2]山东大学齐鲁医院儿科,山东济南250012

出　　处：《山东大学学报（医学版）》2005年第9期860-862,867,共4页Journal of Shandong University:Health Sciences

摘　　要：目的:评价Video-EEG(Video-脑电图)在鉴别诊断小儿发作性疾病中的应用价值,以及对癫痫分类的指导意义。方法:对拟诊为癫痫性发作(ES)的274例患儿和拟诊为非癫痫性发作(NES)的396例患儿,进行1～6h的Video-EEG动态监测。监测包括清醒-睡眠周期,并利用各种诱发试验;监测中和结束后对记录的Video-EEG进行分析,并与原拟的诊断作回顾性对比。结果:①274例临床上拟诊为ES的患儿,平均记录时间5.1h,125例(45.6%,125/274)监测到发作,其中112例(89.6%,112/125)为ES,91例(81.3%,91/112)确定了发作类型,42例(37.5%,42/112)发作类型得到修正;8例(6.4%,8/125)为NES;5例(4%,5/125)为癫痫合并NES。149例(54.4%,149/274)未监测到临床发作,其中78例记录到癫痫样放电;②临床上拟诊为NES的396例患儿平均记录时间2.4h,307例(77.5%,307/396)监测到发作,其中283例(92.2%,283/307)证实为NES,24例(7.8%,24/307)为ES。89例(22.5%,89/396)未监测到发作,其中2例(2.2%,2/89)记录到癫痫样放电。结论:Video-EEG是鉴别诊断ES和NES及明确ES分类的可靠检查方法。Objective： To evaluate the clinical significance of video-EEG monitoring in the differential diagnosis of epileptic seizures（ES） and non-epileptic seizures（NES）, and the value intyping of ES. Methods： Video-EEG monitoring under the states of awaking and sleeping and evoked tests were performed continuously for 1 to 6 hours in 274 children suspected of having ES and 396 NES. Video-EEG monitoring results were analyzed and compared with primary diagnoses retrospectively. Results： ①In the group of 274 children suspected as ES, 5.1 hours were recorded in average ; characteristic events were captured in 125 children （45.6%, 125/274）, among them, 112 cases （89.6%, 112/125） were confirmed as ES,of them, 91 cases were determined the ES types （81.3% ,91/112）, 42 cases were rectified （37.5% ,42/112）; 8 cases（6.4% ,8/125） were defined as NES; 5 cases （4%,5/125） as epilepsy complicated with NES. Seizures were not monitored in 149 cases （54.4% ,149/274）,but epileptiform discharges were recorded in 78. ②In the 396 children suspected as NES, 2.4 hours were recorded averagely; clinical events were captured in 307 children （77.5%, 307/396）, among them, 283 cases （92.2%,283/307） were identified as NES,24 cases （7.8%,24/307） as ESi seizures were not monitored in 89 （22.5%,89/396）,but epileptiform discharges were found in 2 cases （2.2%, 2/89）. Conclusion： Video-EEG is a credible way for differential diagnosis between ES and NES, and for typing of ES.

关 键 词：发作 癫痫 VIDEO-EEG 诊断价值 小儿发作性疾病 

分 类 号：R741.044[医药卫生—神经病学与精神病学] R742.1[医药卫生—临床医学]