视频脑电图监测在抗癫痫药物治疗停药中的指导价值  

Value of video electroencephalogrphy to withdrawal antiepileptic drugs in patients with epi- lepsy

作　　者：梁益[1] 孙红斌[1] 

机构地区：[1]四川省医学科学院·四川省人民医院神经内科,四川成都610072

出　　处：《癫痫与神经电生理学杂志》2014年第1期16-19,共4页Journal of Epileptology and Electroneurophysiology(China)

摘　　要：目的：探讨视频脑电图（V—EEG）监测在癫痫患者停药过程中的应用价值。方法：选择我院经停药后3年以上无癫痫发作的患者139例进行24hV—EEG监测观察其脑电图变化与临床症状之间的关系，并随访4-5年。结果：本组139例患者中接受单药治疗97例，两种药物联合治疗20例，3种药物联合治疗22例，治疗中均无临床癫痫发作。V—EEG监测发现有痫样放电39例（28．1％）。在此39例痼样放电患者中，活动性痫样发作史〈6个月8例、7～12个月9例、〉12个月22例。癫痫样放电出现时间：清醒期6例（15．4％），睡眠期30例（76．9％），清醒期与睡眠期均有痫样放电3例（7．7％），睡眠期痢样放电发生率明显高于清醒期，差异有统计学意义（P〈0．05）。所有患者在随后的3～4年随访期中，39例脑电图异常者继续口服抗癫痫药物，停药后9例复发，复发率为23．1％；100例脑电图正常者，49例病人坚持继续服药，停药后2例复发，复发率为4．1％；另51例患者逐渐减停抗癫痫药，停药后8例复发，复发率为10．0％，明显低于脑电图异常者（P〈0．05）。结论：VEEG的监测结果可以用来指导3年无发作癫痫患者是否适合停药，可作为评价药物疗效及选择停药时机的重要依据。Objective：To explore the clinical value of video electroencephalography（V-EEG） in the treatment withdrawal of antiepileptic drugs. Methods：139 patients without epileptic seizure for more than 3 years in our hospital were monitored for 24 hours by digital V EEG produced by Stellate Company in Canada. The monitoring results and patients＇ clinical symptoms were observed, and followed up for 4 to 5 years. Results： Of 39 patients,97 were treated by one kind of drug,20 with two-kind drugs,22 with three drugs, V EEG suggested 39 （28.1 ~ ） patients had epileptiform discharge. 8 patients had seizures for less than 6 months,9 patients had seizures {or 7412 months,and 22 patients had seizures for more than 12 months. The occurrence time of epileptiform discharge was also recorded, which showed that 6 cases （15.4~） occurred in consciousness,~0 （76.9~） occurred in their sleep,and 5 （7.7~）occurred in the both. The incidence rate of epileptiform discharge during sleep was remarkably than that in the period of consciousness,and the difference was significant （P〈C0.05）. All patients were followed up for 3 to 4 years. 39 patients with abnormal EEG continued to take anti epileptic drugs orally, and 9 cases （23.08~） relapsed related to the withdrawal. Other 100 patients with normal EEG,49 of them continued to take drugs,and only 2 patients relapsed related to the withdrawal. 51 of them gradually reduced the a-mount of anti-epileptic drugs,8 patients relapsed related to the withdrawal. The total relapse rate was 10~ ,lower than that in the patients with abnormal EEG （P^0.05）. Conclusion：The monitoring results of V-EEG can provide references for the withdrawal of antiepileptic drugs.

关 键 词：癫痫 脑电图 停药 

分 类 号：R742.1[医药卫生—神经病学与精神病学] R741.044[医药卫生—临床医学]