15例夜间睡眠期行为异常患者的脑电图及多导睡眠图分析  

Analysis of EEG and polysomnography of 15 patients with abnormal sleep behavior at night

作　　者：吕玉丹[1] 王卓[2] 林卫红[1] 孟红梅[1] 崔利[1] 王赞[1] 

机构地区：[1]吉林大学白求恩第一医院神经内科,吉林长春130021 [2]吉林大学白求恩第一医院放射线科,吉林长春130021

出　　处：《中风与神经疾病杂志》2012年第12期1112-1114,共3页Journal of Apoplexy and Nervous Diseases

摘　　要：目的通过对夜间睡眠期行为异常患者的脑电图及多导睡眠图分析,鉴别诊断额叶癫痫及REM期睡眠行为异常(RBD),并结合文献对其临床表现、电生理特点进行总结。方法对15例夜间睡眠期行为异常患者,均行长程录像脑电图(Video-EEG)及多导睡眠监测(PSG)。并依据国际睡眠障碍分型修订版(ICSD-R)及国际抗癫痫联盟(ILAE)所制定的癫痫综合征分类标准,给予鉴别诊断及相应治疗,随访观察预后。结果其中9例为额叶癫痫患者,其发作间期脑电图,额区、额中线区可见异常放电者7例;发作期脑电图,额区、额中线区可见节律性演变者2例,伴有大量肌肉及动作伪差,行为异常多发作于非快速眼动睡眠Ⅰ～Ⅱ期,睡眠结构中,总睡眠时间缩短、睡眠Ⅲ～Ⅳ期、REM睡眠期缩短、Ⅰ～Ⅱ期睡眠时间延长。6例为RBD患者:发作间期及发作期脑电图正常;PSG记录中,发作均位于REM期,并持续出现肌电活动增加,总睡眠时间、睡眠Ⅰ～Ⅱ期、REM睡眠期均缩短。结论额叶癫痫及RBD的临床症状复杂,容易误诊、延诊,故借助神经电生理检查手段(长程脑电图结合PSG)可以提高疾病的诊断率。Objective To make differential diagnosis of frontal lobe epilepsy and REM sleep behavior abnormalities（RBD） for patients who have abnormal behavior at night,by using electroencephalogram（EEG） and polysomnography（PSG）.Methods EEG and PSG were conducted to 15 cases of patients with nocturnal sleep abnormal,and diagnosis was made on the basis of International Sleep Disorders Revised Edition（ICSD-R） and the International League Against Epilepsy（ILAE）,then treatment and follow-up were performed.Results 9 patients had been diagnosized of frontal epilepsy,among them,7 patients had interictal discharges in frontal lobe and 2 patients had ictal rhythmic evolution in frontal lobe.They showed shorter total sleep time and NREMⅠ~Ⅱsleep time.Other 6 patients had been diagnosized of RBD,who showed a normal interictalictal EEG,but an increased EMG in REM,and normal sleep structure.Conclusion Frontal lobe epilepsy and RBD have often been misdiagnosed for complex clinical symptoms,long-term EEG combined with PSG can improve the diagnosis rate.

关 键 词：RBD 额叶癫痫 多导睡眠图 长程录像脑电图 

分 类 号：R742.1[医药卫生—神经病学与精神病学]