剥夺睡眠脑电图在儿童非癫性发作的价值  

Value of Sleep-Deprivation Electroencephalography in Children with Nonepileptic Seizures

作　　者：陈连红[1] 庞清忠[1] 陆燕芬[1] 陈丽琴[1] 

机构地区：[1]上海交通大学附属儿童医院新生儿科,上海200040

出　　处：《实用儿科临床杂志》2007年第2期129-130,132,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的比较非癫痫性发作、疑似癫痫及正常儿童对剥夺睡眠脑电图检查诊断的敏感性及实用价值。方法选择临床表现酷似癫痫发作38例（男13例，女25例；年龄4～12岁，平均8．1岁），有明确诱发因素，行常规EEG及剥夺或部分剥夺睡眠——睡眠EEG诱发试验，作自身对照，除脑电异常放电者。同时随机抽取有反复发作疑似癫痫、且常规脑电图检查正常102例（男63例，女39例；年龄3～12岁，平均7．3岁）与106例（男57例，女49例；年龄3～12岁，平均7．6岁）无癫痫临床发作史的对照组，以同样方法的诱发试验作比较。结果所有病例脑电图的背景电活动频率均明显变慢。非癫痫发作组38例睡眠EEG诱发试验均为阴性，因其诱发试验前后数据一致，故该组无统计意义；拟诊癫痫组脑电图有棘／尖慢复合波等癫痫样放电者57例（55．9％）；对照组诱发后脑电图异常出现2例（1．9％）癫痫样放电者，3组比较有非常显著差异（X^2=97．3 P〈0．01）。结论剥夺睡眠后脑电图出现癫痫样电活动的敏感性高于常规脑电图检查，拟诊癫痫的敏感性高。该检查对非癫痫样发作排除癫痫有实用价值。Objective To compare the sensitivity of sleep - deprivation electroencephalography （EEG） examination on children suffered with nonepileptic seizures in normal and suspected epileptic in children. Methods Thirty - eight children with nonepileptic seizures （ male 13, female 25, age 4 - 12 years, mean 8.1 years） had induced a person to make a confession. One hundred and six normal children （ male 57, female 49, age 3 - 12 years, mean 7.6 years） and 102 children （ male 63, female 39, age 3 - 12 years, mean 7.3 years） suspected of epilepsy clinically but with normal standard EEG examination were selected at random as controls. Sleep - deprivation EEG was performed individually. Results The sleep deprivation EEG showed slow background electric activity in all 3 groups. In addition, the rates of EEG abnormality for nonepileptic seizures group were zero, no statistics were computed because F was a constant. Fifty - seven cases showed spindle/sharp - slow wave complex in suspected epileptic children. The rate of EEG abnormality was 55.9%. The rate of EEG abnormality for normal control group was 1.9 %. There were significant difference among 3 groups （X^2 = 97.3 P 〈 0.01 ）. Conclusions Sleep - deprivation EEG is more sensitive than standard EEG and suspected of epilepsy is more sensitive to abnormal electric activity. It has practical value clinically for excluding the diagnosis of epilepsy from children with nonepileptic seizures.

关 键 词：剥夺睡眠 脑电描记术 儿童 非癫痫性发作 

分 类 号：R748[医药卫生—神经病学与精神病学]