婴儿痉挛症60例临床和视频脑电图特点  

Clinical Manifestation and Video-Electroencephalogram Featurs of 60 Infantile Spasm

作　　者：金瑞峰[1] 王纪文[2] 高在芬[1] 田广燕[1] 于振华[2] 孙若鹏[2] 

机构地区：[1]山东大学齐鲁儿童医院神经科,济南250022 [2]山东大学齐鲁医院儿科,济南250022

出　　处：《实用儿科临床杂志》2009年第1期56-57,66,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的通过视频脑电图(VEEG)观察婴儿痉挛症发作时和发作间期的脑电图特点,评价其与预后的关系。方法住院婴儿痉挛症患儿60例。男43例,女17例;发病年龄1～12个月。应用1161B型视频脑电监视系统对60例婴儿痉挛症行VEEG长时间监测,VEEG分析包括背景节律,是否对称,快波暴发、高幅慢波和去同步化,发作形式等。结果60例患儿中,电视录像记录到263次痉挛发作,EEG共记录到318次发作波(105成串发作,98次孤立发作,115次其他形式发作),伴局限性发作者均为继发性婴儿痉挛,清醒时痉挛发作36例,睡眠期发作24例。曲屈型42例(72%),伸展型7例(12%),混合型11例(16%);35例(58%)为对称发作,大多为隐源性,也可见症状性;不对称发作25例(21%)。药物治疗不能明显减少局限性发作。结论VEEG对婴儿痉挛症发作类型和发作形式的确定及其诊断有较大的应用价值,对判断预后也有较好的参考价值。Objective To investigate ictal and interictal electroencephalogram（EEG） characters of infantile spasm and to evaluate treatment responses by video - EEG（VEEG） on the oneset and during the onset. Methods Clinical data and VEEG findings were subject to the comparison in 60 cases （43 male and 17 female,aging 1 - 12 months） based on long term recordings by type lI61B VEEG. VEEG analysis was performed visually for interictal background activity,ictal events：spasms and other seizures either generalized or partial,high voltage slow wave complex,fast wave bursts,and desynchronization. Results Three hundred and eighteen seizures （ including 105 clusters of spasms,98 isol spasms and 115 other spasms） were recorded by EEG and 263 seizures were recorded by VEEG in 60 patients. The infantile spasm was endeictic if with partial seizures. Seizures at awake time were 36 cases and at sleep period were 24 cases~ Among the 60 patients,flexor type 42 cases, extensor type 7, cases and mixed flexor/extensor type 11 cases. Thirty - five cases were symmetrical spasms,most of which were cryptogenie,symptomatic spasms cauld be seen too. And asymmetrical spasms were 25 cases （21%）. Drug therapy could not relieve partial seizure onset. Conclusions Specifical changes in V EEG, which are vety important to the diagnosis of West syndrome,may contribute to etiologic diagnosis and prognostic evaluation.

关 键 词：婴儿痉挛 视频脑电图 抗癫痫药 

分 类 号：R742.1[医药卫生—神经病学与精神病学]