不同发作类型的婴幼儿癫视频脑电图特征  

Video Electroencephalogram Characteristics of Different Seizure Types in Infants with Epilepsy

作　　者：宋莉[1] 陈彦[2] 廖建湘[2] 陈黎[2] 徐雅娜[2] 路新国[2] 文家伦[2] 张端秀[1] 

机构地区：[1]遵义医学院研究生院,贵州遵义563003 [2]深圳市儿童医院神经内科,广东深圳518026

出　　处：《实用儿科临床杂志》2012年第10期771-773,共3页Journal of Applied Clinical Pediatrics

基　　金：广东省医学科研基金(A2000628)

摘　　要：目的通过视频脑电图(VEEG)分析癫婴幼儿的发作类型。方法对深圳市儿童医院7 a来2岁以下且VEEG监测到发作性事件的1 000例患儿的临床资料进行回顾性分析。结果 1.全面性发作41例。其中强直-阵挛发作4例,持续时间为(59.75±58.93)s,中位数(M)38.50 s。强直相持续(17.25±15.81)s,M 12.50 s;阵挛相持续(35.00±29.54)s,M 29.00 s。发作期EEG主要表现为全导脑波抑制、全导棘波或低幅快活动发放后转变为棘波频率变慢夹杂慢波交替出现。强直发作6例,持续时间(36.66±16.97)s,M 34.00 s,发作期EEG为低中幅快节律持续发放。肌阵挛31例,持续时间(186.67±29.16)ms,M 200.00ms,发作期EEG为多尖棘慢波全导同发。2.痉挛发作302例。其中1岁内219例,1～2岁83例。发作持续时间为(1.35±0.67)s,M 1.00 s,发作间期背景EEG为高峰节律紊乱,其中210例为变异性高峰节律紊乱。临床表现屈肌型216例,伸肌型29例,混合型22例,眼球运动、轻微抖动等不典型发作35例。3.局限性发作232例。持续时间(107.34±104.88)s,M 70.00 s。临床表现为强直抖动(阵挛)样发作或无动性凝视(肢体无明显动作,肌张力无改变),多数意识状态难以准确判断,发作间期EEG为局限性癫样放电,EEG观察发作起源于额区13例、中央区20例、颞区46例和枕区13例,其余为多个部位起源,其中17例发作间期和起源部位不一致。4.癫持续状态10例。发作时临床表现为自动症或单侧肢体强直抖动为主,发作时间持续30 min以上或者反复发作,各次发作间意识未恢复至正常水平,EEG为局限性持续癫样放电。5.多种形式的发作43例,VEEG主要表现为一次发作中出现多种发作类型,痉挛伴局限性发作31例,痉挛伴肌阵挛发作11例,痉挛伴局限性发作、肌阵挛发作1例。6.非癫性发作372例。清醒期发作214例,睡眠期发作111例,清醒及睡眠期均有发作47例。突出表现为轻微抖动,非性强直等现�Objective To investigate the seizure types in infants by means of video electroencephalogram（VEEG）. Methods The cli- nical data of 1 000 children captured with VEEG under the age of 2 years at Shenzhen Children＇s Hospital in last 7 years,who were with suspi- cion of epilepsy, were analyzed. Results 1. Generalized seizures included 41 cases which there were tonic - clonic seizures in 4 cases, with at- tack duration（59.75 ±58.93 ） s, and median （M） was 38.50 s. Tonic duration was （ 17.25 ± 15.81 ） s, and M was 12.50 s. Clonic lasted for （ 35.00 ±29.54 ） s, and M was 29.00 s. During the stage of attack EEG showed all the inhibition of brain wave and spike wave or fast movement in small amplitude released into slow spike wave mingled with slow wave. Tonic seizures in 6 cases, during the stage of attack EEG showed low fast rhythm and attack duration （36.66 ±16.97） s,and M was 34.00 s;myoclonic seizures in 31 cases,during the stage of attack EEG showed spike - and - slow waves with attack duration （ 186.67 ±29.16） ms,and M was 200.00 ms. 2. Epileptic spasms in 302 cases, with 219 patients within 1 year old,and 83 patients 1 to 2 years old. Attack duration （1.35 ＋ 0.67）s,and M was 1.00 s,which showed hypsarrhythmia in background EEG,in which 210 patients with hypsarrhythmia in variants. Clinical manifestation of flexor type in 216 cases,ex- tensor muscles type in 29 cases,mixed in 22 cases,eye movement with slight shaking of untypical attack were 35 cases. 3. Partial seizures in 232 cases, attack duration （ 107.34 ± 104.88 ） s, and M was 70.00 s. The prominent manifestations were stiffness jitter and less or staring with no movement. Other seizure types included simple automatisms and mild convulsive seizures. Partial seizures from frontal area were in 13 cases, from central area were in 20 cases, from temporal area were in 46 cases and occipital areas in 13 cases, with multiple area of origin in 17 cases. 4. Epilepticus status in 10 cases, during the attack the clinical man

关 键 词：癫 发作类型 婴幼儿 视频脑电图 

分 类 号：R742.1[医药卫生—神经病学与精神病学]