长程脑电图监测对儿童发作性疾病的诊断价值  

The value of ictal ambulatory electroencephalography in diagnosis to children with paroxysmal events according to sleep

作　　者：郭亚乐[1] 黄绍平[1] 杨琳[1] 周戬平[1] 李静[1] 何娟[1] 邓艾玲[1] 刘慧[1] 李娜[1] 

机构地区：[1]西安交通大学医学院第二附属医院儿科,西安710004

出　　处：《陕西医学杂志》2010年第1期47-49,55,共4页Shaanxi Medical Journal

摘　　要：目的:探讨长程脑电图(AEEG)监测对儿童发作性疾病的诊断价值。方法:对因与睡眠相关的发作性事件首次前来我院门诊及住院诊治的儿童222例进行AEEG监测,得到癫痫事件(ES)或非癫痫事件(NES)的初步诊断。再根据临床症状、体征、AEEG、部分患儿加做心电图、头颅CT、血液生化检查(包括血糖、血氨、心肌酶谱)等,以及根据治疗转归综合分析,得到确定诊断。分析AEEG检查对儿童睡眠相关的发作性事件的诊断意义。结果:脱失率为3.15%,坚持随访的患儿215例(96.9%)。AEEG初步诊断,ES有105例,NES117例,其中56例(25.2%)监测中有发作性事件的儿童中,16例(7.2%)在事件同时有痫样放电,为ES,40例(18.0%)在事件同时无痫样放电,为NES。166例未扑捉到发作性事件的儿童,89NES。监测中捕捉到发作性事件的NES儿童40例,其中26例NES有发作间期的痫样放电,占总样本的11.7%。依靠AEEG诊断的105例ES中8例随访例(40.1%)有发作间期痫样放电,为ES,77例(34.7%)无发作间期痫样放电,为后排除,117例NES中1例随访后诊断为ES。临床随访后综合分析发现,98例(44.1%)为ES,117例(52.7%)为NES。AEEG与确诊诊断符合率为95.9%。NES中包括:儿童情绪障碍12例(5.4%)、偏头痛28例(12.6%)、晕厥17例(7.7%)、睡眠障碍27例(12.2%)(包括发作性睡病7例,3.2%)、抽动症8例(3.6%)、多发性抽动25例(11.3%)。结论:AEEG可提高儿童与睡眠相关的发作性事件的诊断率。Objective：To investigate the value of AEEG in diagnosis to children with paroxysmal events according to sleep. Methods：222 children with paroxysmal events which were according to sleeps. The primary diagnosis would been got by AEEG,then the confirmed diagnosis would been made by their symptoms,physical signs,AEEG,ECG,CT of the skull,blood examination（blood sugar,blood ammonia,myocardium myze ） recovery after therapy. Results：3.15 % children had lost. 215 children （96.9%）had insisted to the last visit. There were 105 children were ES,117 children were NES who were primary diagnosed by AEEG ,56 （25.2%） children＇s paroxysmal events had been mornitored in the AEEG process,16 children（7.2%）who had epileptic discharge were ES;40 children （18.0%）who had no epileptic discharge were NES. 166 children＇s paroxysmal events had not been mornitored in the AEEG process,89infants （40.49%） who had epileptic discharge in interval were ES,77 children （34.7%） who had no epileptic discharge were NES.26 children of the 40 NES children had no epileptic discharge when events happened but had epileptic discharge in interval who were NES and whose paroxysmal events had been mornitored in the AEEG process ,the rate was 11.71% to the whole sample. Their confirmed diagnosis were：8 children in 105 ES children who had been diagnosed by AEEG were NES ,1 child in 117 NES children who had been diagnosed by AEEG had the follow-up study results as ES. By the follow-up study for at lest 1 month after,the results were ：there were 98 children （44.1%） were ES,117children （52.7%） were NES. The coimcidence rate of diagnose epileptic to by AEEG to follow-up study was 95.9%.NES includes：12 children （5.4%）were disturbance of affect,28 children （12.6%）were headaches,17children（7.7%）were faint,27children（12.2%）were somnipathy （included 7 children,3.2% were narcolepsy）,8 children （3.6%）were tic,25 children （11.3%）were multiple tic. Conclusion：We suggest that AEEG should be used t

关 键 词：癫痫/诊断 睡眠障碍/诊断 脑电图描记术 儿童 

分 类 号：R725.4[医药卫生—儿科]