复杂性热惊厥病儿动态脑电监测的临床价值  

THE CLINICAL VALUE OF DYNAMIC EEG MONITORING IN CHILDREN WITH COMPLEX FEBRILE SEIZURES

作　　者：袁凯杰[1] 侯梅[1] 郭洪磊[1] 王新强[1] 万鑫[1] 

机构地区：[1]青岛大学医学院附属青岛市妇女儿童医院神经康复科,山东青岛266011

出　　处：《青岛大学医学院学报》2013年第5期412-414,共3页Acta Academiae Medicinae Qingdao Universitatis

摘　　要：目的探讨复杂性热惊厥病儿24h动态脑电监测的临床价值。方法回顾性分析2011年1月—2012年10月在我院癫痫门诊就诊、符合复杂性热惊厥诊断标准的50例病儿惊厥发作后的常规脑电图及24h动态脑电图监测结果,分析痫样放电情况及其相关因素。结果复杂性热惊厥病儿24h动态脑电图痫样放电的检出率(60%)明显高于常规脑电图(6%)(χ2=32.972,P<0.05);动态脑电图痫样放电检出率与发作年龄(>3岁)有关(χ2=4.778,P<0.05),而与惊厥家族史、发作频率、低温惊厥、部分性发作、持续时间(≥15min)及一次热程多次发作无关。30例脑电异常者中,全面性棘(尖)慢波放电23例,局灶性痫样放电7例。结论 24h动态脑电监测可明显提高痫样放电的检出率,3岁以上复杂性热惊厥病儿首选动态脑电监测,该监测有助于预后判断和用药指导。Objective To assess the value of dynamic EEG monitoring for children with complex febrile seizures （CFS）. Methods A retrospective review was conducted in 50 children who visited our epilepsy clinic （during 2011.01-2012.10） and con- sistent with diagnostic criteria of CFS. Their post seizures routine EEG and 24-hour dynamic EEG were analyzed for epileptiform discharge （ED） and its related factors. Results The detection rate of ED in 24-hour dynamic EEG in CFS children was 60%, which was higher than routine EEG （6%） （X^2=32.972,P〈0.05）. The detection rate of ED in dynamic EEG was related with the age of onset （〉3 years old） （X^2=4.778,P〈0.05）, and not associated with a family history of febrile seizures, seizure frequency, lower temperature seizure, partial seizures, persistent time （≥15 min） and multiple seizures in one febrile course. Among 30 with abnormal EEG, 23 were having generalized spike and slow wave, seven with focal ED. Conclusion A 24-hour dynamic EEG monitoring can markedly raise the detection rate of ED, and conduce to prediction of prognosis and guidance of medication, which is the first choice for children with CFS of older than 3-year-old.

关 键 词：惊厥 发热性 脑电描记术 癫痫 危险因素 

分 类 号：R742.1[医药卫生—神经病学与精神病学]