835例癫痫及发作性疾病动态脑电图分析  

AEEG analysis of 835 cases epilepsy and paroxysmal disease

作　　者：许璐[1,2] 喻廉[1,2] 

机构地区：[1]安徽省立医院南区神经电生理室 [2]安徽省脑立体定向神经外科研究所,合肥230036

出　　处：《立体定向和功能性神经外科杂志》2014年第4期220-223,共4页Chinese Journal of Stereotactic and Functional Neurosurgery

摘　　要：目的分析癫痫及发作性疾病患者的动态脑电图（ambulatory EEG monitoring,AEEG）,探讨其在诊断和鉴别诊断的中的价值。方法对2010年7月-2014年6月间,本院住院、门诊中临床诊断为癫痫475例及发作性疾病360例患者进行动态脑电图监测并分析。结果癫痫组动态脑电图（AEEG）与常规脑电图（routing-EEG,REEG）比较痫样放电检出率和异常率均有显著差异（P〈0.01）。癫痫组与发作性疾病组比较痫样放电检出率和异常率均有显著差异（P〈0.01）。痫样放电多见于睡眠期,以非快速眼动睡眠Ⅰ-Ⅱ期（NREMⅠ-Ⅱ期）为主。在脑电图记录过程中,癫痫组有临床发作36例：5例仅在发作期可见痫样放电,发作间期未见痫样放电;31例两期均可见痫样放电。发作性疾病组有临床发作44例：2例仅发作期可见痫样放电,发作间期未见痫样放电;4例两期均可见痫样放电;其余均未见痫样放电,占86.4%。结论癫痫及发作性疾病患者AEEG检查痫样放电检出率优于REEG检查;在临床症状类似癫痫的发作性疾病中,AEEG及REEG痫样放电检出率只为8.6%及3.6%。因此,发作性疾病需要行AEEG检查,帮助鉴别诊断和确诊。Objective To explore the value of AEEG in diagnosis and differential diagnosis through the analysis of epilepsy and seizure disorders.Methods AEEG was carried out and analyzed in 475 epileptics and 360 Seizure disorders inpatient and outpatient in hospital during Jul.2010-Jun.2014.Results The epileptic discharge of REEG and AEEG in epilepsy group detection rate and the total abnormal rate had significant differences（P〈0.01）.The epileptiform discharges were mainly found during NREM phase.Most in the-Ⅱ stages of NREM sleep.In epilepsy group,there were 36 cases of clinical seizures.5 cases had no ES during their nonseizures,but showed during their seizures.31 cases were seen epileptiform discharges in both stage.In seizure disorders group,there were 44 cases of clinical seizures.2 cases had no ES during their nonseizures,but showed during their seizures.4 cases showed epileptiform discharges,the rest had no ES（86.4%）.Conclusion The epileptiform discharges in AEEG is better than it which in REEG,both epilepsy and Seizure disorders.In the clinical symptoms to the attack of epilepsy disease,AEEG and REEG detection rate of epileptiform discharge only 8.6% and 3.6%,therefore,Seizure disorders need AEEG which can help to diagnosis and differential diagnosis of epilepsy and Seizure disorders.

关 键 词：癫痫 发作性疾病 动态脑电图 

分 类 号：R742.1[医药卫生—神经病学与精神病学]