208例成人痫性发作患者的视频脑电监测结果分析  

Analysis of video EEG monitoring in 208 cases of adult patients with epileptic seizure

作　　者：刘姝[1] 苏庆杰[1] 曾超胜[1] 周经霞[1] 黄如萍[1] 

机构地区：[1]海南省农垦总医院神经内科,海南海口570311

出　　处：《海南医学》2014年第20期2981-2983,共3页Hainan Medical Journal

基　　金：海南省卫生厅2011年度科研项目(编号:琼卫2011-70)

摘　　要：目的探讨视频脑电监测技术对成人痫性发作的鉴别诊断作用。方法采用美国尼高力公司生产的32导程视频脑电仪描记系统,对208例经体检疑诊痫性发作的成人患者进行24 h长程视频头皮脑电监测,通过回放分析患者发作期、发作间期、发作后脑电图表现,分析其阳性及阴性似然比。结果通过临床查体、发作过程观察结合同步脑电图表现以及用药是否有效等手段得出可靠的临床癫痫确诊患者191例,其中脑电图阳性(脑电图上出现尖波、棘波、尖慢波、棘慢波、多棘慢波或快节律等痫性波)者146例,这包括捕捉到发作者104例,这104例患者同步脑电图均出现痫样放电,阴性者45例,非癫痫患者17例,其中脑电图阳性者13例,阴性者4例,这包括出现发作者5例,同步脑电图均未发现痫样放电。阳性似然比为99.9%,阴性似然比为100.0%。208例患者仅通过询问病史,体检而未行脑电图检查,诊断癫痫患者142例,非癫痫患者66例,阳性似然比为86.0%,阴性似然比为88.1%。两组比较差异均有统计学意义(均P<0.05)。结论视频脑电可以有效提高成人痫性发作患者的确诊率,具有重要的临床应用价值。Objective To explore the value of video-electroencephalogram （video EEG, VEEG） monitoring technology in the differential diagnosis for adult epileptic seizure. Methods Two hundred and eight adult patients with suspected seizure underwent 24 hours LTM by 32--way VEEG trace system （American high-power eompany＇s product）, and then the VEEG recorded data of seizure time, interictal, and afterwards time were reviewed and analyzed to explore the positive and negative likelihood ratios. Results 191 reliable clinical epilepsy patients were confirmed based on physical examination, symptoms during seizure, synchronizing EEG performance, and corresponding medication effects, including 146 eases of positive and 45 cases of negative EEG. Among the patients with positive ECG epileptic wave, such as sharp, spike, sharp complex, spike complex, poly spike complex, or fast rhythm pattern in EEG）, 104 cases of paroxysmal patients were all detected with epileptic discharge in synchronizing EEG. Meanwhile, 17 cases of non-epilep- sy （13 positive included 5 seizure patients without epileptic discharge in synchronizing EEG, 4 negative） were observed. The positive and negative likelihood ratios were 99.9% and 100.0% respectively. In another 208 patients, 142 cases of ep- ilepsy and 66 eases of non-epilepsy were diagnosed only by medical history and physical examination without EEG, where the positive and negative likelihood ratios were 86.0% and 88.1%. There was statistical difference between the two groups （P〈0.05）. Conclusion VEEG can effectively improve the diagnostic rate in adult epileptic patients, which shows an important clinical value.

关 键 词：视频脑电图 痫性发作 似然比 

分 类 号：R741.044[医药卫生—神经病学与精神病学]