头皮脑电图记录高频振荡成分在伴中央颞区棘波的儿童良性癫痫中的临床应用  

Clinical significance of high-frequency oscillations recorded by scalp electroencephalogram on benign childhood epilepsy with centro-temporal spike

作　　者：操德智[1,3] 陈彦[1] 朱艳伟[1] 张军[1] 胡湛棋[1] 赵霞[1] 胡雁[1] 陈黎[1] 文飞球[1] 翟琼香[2] 廖建湘[1] 

机构地区：[1]重庆医科大学附属深圳市儿童医院神经内科,518026 [2]广东省人民医院儿科 [3]南方医科大学

出　　处：《中华实用儿科临床杂志》2014年第12期895-898,共4页Chinese Journal of Applied Clinical Pediatrics

基　　金：深圳市科技计划资助项目（201203077）

摘　　要：目的探索头皮脑电图记录高频振荡成分（HFOs）的方法，研究HFOs与伴中央颞区棘波的儿童良性癫痫患者预后的关系。方法收集62例伴中央颞区棘波的儿童良性癫痫病例，随访2年，定期通过高采样率的头皮脑电图捕捉脑电活动中的快波（80—500Hz，又叫HFOs），同时进行智力测试，根据患者用药后的癫痫发作控制情况，将其分为2组（良性组和不良组），比较2组的智商水平以及脑电图情况，分析HFOs的出现与患者预后的关系，同时观察HFOs的临床特征。结果在62例伴中央颞区棘波的儿童良性癫痫病例中良性组52例，不良组10例。入组时2组智商水平差异无统计学意义，随访1年及2年后，2组的智商水平差异有统计学意义。4例患儿中记录到HFOs，其频率为83．3—172．4Hz，波幅为5—25μV，持续时间为80～200ms，这种特殊成分与常规脑电图中的棘波成分重叠出现，但二者性质完全不同。同时通过常规视频脑电图先后在12例患儿中记录到睡眠中癫痫电持续状态。通过统计学分析，HFOs以及睡眠中癫痫电持续状态都与患儿预后有关，但HFOs出现更早，特异性更高，与预后的关系更密切。结论通过提高头皮脑电图的采样率，可以清晰记录到HFOs，其与患者的预后有密切的关系，可以作为预测伴中央颞区棘波的儿童良性癫痫患儿预后的新的特异性强的生物标志物之一。Objective To explore the method for recording high-frequency oscillations （HFOs） by scalp electroencephalogram （EEG）, and to analyze the relationship between HFOs（ 80 -500 Hz） and prognosis on benign child- hood epilepsy with centro-temporal spike （BCECTs）. Methods Sixty-two cases of BCECTs were enrolled and followed up for 2 years. The scalp EEG and intelligence examination were performed each year. HFOs （80 -500 Hz） were recorded by scalp EEG with high sampling rate. All cases were divided into 2 groups （ the benign group and the non-benign group） according the condition of seizure attack after drug administration. The relationship between HFOs and the prognosis were analyzed. The characteristics of HFOs were described. Results Fifty-two of them belonged to the benign group,and the other 10 cases of them belonged to non-benign group. There was no significant difference in intelligence quotient between 2 groups when they were enrolled. But there were significant differences between them after one-or- two-year follow-up. HFOs were recorded in 4 cases of BCECTs. The frequencies, amplitudes and durations of them were respectively 83.3 -172.4 Hz,5 -25 μV and 80- 200 ms. HFOs were superimposed in the phase of spikes,however the characteristics were completely different. Electrical status epilepticus during sleep （ESES） was recorded successively in 12 cases by the routine video-EEG. Both of HFOs and ESES were related to the prognosis. But HFOs could be identified earlier and more specifically than ESES, and they were more closely related to the prognosis than ESES. Conclusions HFOs can be recorded clearly by scalp EEG with high sampling rates, which is highly related to the prognosis of the patients. The emerging of HFOs indicates the poor prognosis of BCECTs. HFOs can be used as a new specific biomarker to predict the prognosis of BCECTs.

关 键 词：高频振荡成分 伴中央颞区棘波的儿童良性癫痫 睡眠中癫痫性电持续状态 头皮脑电图 预后 生物标志物 

分 类 号：R742.1[医药卫生—神经病学与精神病学]