继发性癫痫诊断及疗效的脑电图研究  

Electroencephalogram research of diagnosis and curative effect for secondary epilepsy

作　　者：王艺玲 欧阳青 黎燕飞 雷叶青 王海裕 WANG Yi-ling OUYANG Qing LI Yan-fei et al(Guangdong Taishan City People＇s Hospital, Taishan 529200, Chin)

机构地区：[1]广东省台山市人民医院,529200

出　　处：《中国实用医药》2016年第30期10-12,共3页China Practical Medicine

基　　金：广东省江门市卫计局科研项目[项目编号:江卫(2014)201号-14A137]

摘　　要：目的探讨继发性癫痫原发病病灶部位、癫痫首发时间与脑电图异常发现的相关性及治疗后癫痫发作情况与脑电图变化。方法回顾性分析136例继发性癫痫患者的临床资料及脑电图,并观察疗效。结果原发病灶位于脑叶皮质的脑电图异常率为90.57%,其中癫痫样放电检出率为52.83%,而原发病灶位于皮质下脑电图异常率为60.00%,其中癫痫样放电检出率为20.00%。原发病灶位于脑叶皮质的脑电图异常率及癫痫样放电检出率均比皮质下高,差异具有统计学意义(P<0.01)。脑血管病、颅内感染、颅脑外伤的早发癫痫脑电图异常率为分别为56.41%、50.00%、60.00%,均高于迟发癫痫脑电图异常率(30.77%、25.00%、20.00%);而脑瘤、脑病则相反,迟发癫痫脑电图异常率分别为85.71%、75.00%,均高于早发癫痫脑电图异常率(0、25.00%)。136例患者经治疗,随访3、6、12个月无癫痫发作率分别为55.88%、75.00%、86.76%,复查脑电图异常率(癫痫性放电检出率)分别为39.71%(20.59%)、22.06%(11.76%)、13.24%(4.41%)。结论继发性癫痫原发病病灶在脑叶皮质者脑电图异常率、癫痫样放电率高,不同病因的继发性癫痫首发时间不同,脑电图异常率也有所不同。经治疗后随着病情好转,发作次数减少,脑电图异常率、癫痫样放电率亦低,因此,脑电图在继发性癫痫的诊断及疗效监测均提供重要参考价值。Objective To investigate correlation between primary lesion of secondary epilepsy, primary onset time and electroencephalogram abnormality, along with epilepsy onset states and electroencephalogram changes. Methods A retrospective analysis was made on clinical data and electroencephalogram of 136 patients with secondary epilepsy. Their curative effects were observed. Results Electroencephalogram abnormality rate in lobe cortex as primary lesion was 90.57%, with detection rate of epileptiform discharge as 52.83%. Electroencephalogram abnormality rate in subcortex as primary lesion was 60.00%, with detection rate of epileptiform discharge as 20.00%. Lobe cortex as primary lesion showed all higher electroencephalogram abnormality rate and detection rate of epileptiform discharge than subcortex, and the difference had statistical significance（P〈0.01）. Electroencephalogram abnormality rates of early epilepsy were respectively 56.41%, 50.00% and 60.00% in cerebrovascular disease, intracranial infection and craniocerebral trauma, which were all higher than electroencephalogram abnormality rates of delayed epilepsy（30.77%, 25.00%, 20.00%）. Electroencephalogram abnormality rates of delayed epilepsy in brain tumor and encephalopathy were all higher as 85.71% and 75.00% than those of early epilepsy（0, 25.00%）. After treatment, follow-up taken by 136 patients for 3, 6, 12 months showed incidence of non epilepsy as 55.88%, 75.00% and 86.76%, along with electroencephalogram abnormality rate（detection rate of epileptiform discharge） in reexamination as 39.71%（20.59%）, 22.06%（11.76%） and 13.24%（4.41%）. Conclusion Secondary epilepsy with lobe cortex as primary lesion shows high electroencephalogram abnormality rate and epileptiform discharge rate. Various pathogenesis of secondary epilepsy provide different primary onset time and electroencephalogram abnormality rate. Improvement of disease after treatment leads to decreased onset time, electroencephalogram abnormality rate and epileptiform discharge

关 键 词：继发性癫痫 脑电图 癫痫样放电 

分 类 号：R742.1[医药卫生—神经病学与精神病学]