癫痫发作期与发作间期视频脑电监测的价值  

The Value of Ictal and Interictal Video-EEG Monitoring for Patients with Epilepsy

作　　者：刘南平[1] 陈景云[1] 李伟旺[1] 潘宗[1] 孙涛[2] 

机构地区：[1]宁夏医科大学附属医院神经电生理科宁夏颅脑疾病重点实验室,银川750004 [2]宁夏医科大学附属医院神经外科宁夏颅脑疾病重点实验室,银川750004

出　　处：《宁夏医科大学学报》2010年第7期759-761,共3页Journal of Ningxia Medical University

基　　金：国家自然科学基金项目(30750014)

摘　　要：目的探讨癫痫发作期和发作间期视频脑电监测脑电异常变化对癫痫诊断、鉴别诊断及致痫灶定位的应用价值。方法采用美国Bio-logic视频脑电监测系统,对73例临床诊断为癫痫的患者进行视频脑电监测,并进行过度换气、睁闭眼、闪光刺激等诱发试验。双视频监测发作情况(全身及局部),记录完整清醒睡眠觉醒周期内脑电图变化(24h)。结果 73例患者在监测中均有临床发作(1次或数次不等),发作仅出现在睡眠中37例(50.7%),仅发生于清醒期17例(23.3%),清醒与睡眠中均有发作18例(24.7%)。1例发作时脑电无异常变化(最终诊断为癔病);72例(98.6%)发作同期脑电信号有异常改变,有较明确起始部位的30/72例(41.7%):发作间歇期有痫波发放39例(54.9%);发作期与发作间期脑电图异常分布的符合率为53.3%(16/30);发作间期以棘-慢复合波暴发为主,而发作期脑电图以动态变化为特点。结论癫痫脑电图表现形式多样,发作起始的脑电局限异常提示异常放电的起源部位,有助于癫痫的分类、致痫灶定位,为癫痫手术治疗提供重要的价值,并可指导临床用药。Objective To investigate the value of abnormalities in ictal and interictal video-EEG monitoring for diagnosis,differential diagnosis and localization of epileptic foci in patients with epilepsy.Methods Using American Bio-logic video EEG monitoring system,73 cases of patients diagnosed with epilepsy were monitored by video-EEG.All cases were performed hyperventilation,opening and closing eyes and flash-induced stimulation test.The situation of seizure（systemic and local） and the integrated and clearly changes of EEG in sleep-awakening cycle（24h） were recorded by dual video monitor.Results All cases had clinical seizure during V-EEG monitoring（1 or more times）.37 cases（50.7%） were observed onset only during sleeping,while 17 cases（23.3%） were found onset only during lucid interval and 18 cases（24.7%） were recorded onset both during sleeping and waken.1 case onset showed normal EEG（eventually diagnosed as hysteria）;72（98.6%） cases with abnormally ictal EEG changes.30（41.7%）cases had a clear starting position in ictal EEG.39 cases（54.9%） were recorded interictal spike wave EEG.The coincidence of abnormal distribution in ictal and interictal EEG was 53.3%（16/30）.Interictal EEG were dominated with spike-slow waves and ictal EEG were dominated with dynamic changes.Conclusion The performance of epilepsia EEG is diversified.The clinical seizure onset dominated with the dynamic changes which suddenly distinguished from background rhythmicity and amplitude.The start of localizated abnormal EEG prompt the epileptogenic zone of paradoxical discharge.It can help to classified epilepsy,location of epileptogenic zone,and to provide the significant value of surgical treatment for epilepsy and to guide clinical medication.

关 键 词：癫痫 视频脑电监测 痫波发放 致痫灶定位 

分 类 号：R742.1[医药卫生—神经病学与精神病学]