枕叶癫痫的视频脑电图分析  

Video electroencephalogram in occipital lobe epilepsy

作　　者：甘欢欢[2] 王钟瑾[1] 明文杰 郭谊[1] 丁美萍[1] Gan Huanhuan Wang Zhongjin Ming Wenjie Guo Yi Ding Meiping(Epilepsy Center, Second Affiliated Hospital, Medical School, Zhejiang University, Hangzhou 310009, China Electrophysiological Group, Department of Functional Inspection, Taizhou Municipal Hospital of Zhejiang Province)

机构地区：[1]浙江大学医学院附属第二医院癫痫中心,杭州310009 [2]台州市立医院功检科电生理组,318000

出　　处：《中华神经医学杂志》2017年第10期984-988,共5页Chinese Journal of Neuromedicine

基　　金：国家自然科学基金面上项目（81471316）

摘　　要：目的探讨枕叶癫痫（OLE）患者视频脑电图（VEEG）特点，以提高OLE临床正确诊断率。方法回顾性收集自2013年6月至2017年2月在浙江大学医学院附属第二医院癫痫中心行VEEG检查的OLE患者25例，分析其临床症状及VEEG特异表现。结果25例患者在既往病史中有视觉先兆的有19例，比例为76．00％；VEEG监测到发作的13例中有5例出现视觉症状．比例为38．46％。VEEG显示发作间期痫样放电局限于枕叶3例，局限于后颞2例．放电累及2个脑区或以上20例。13例监测到癫痫发作的患者中有8例发作期显示枕区有明确放电起源或脑电图最早演变；5例显示其他脑区或全导的异常脑波活动，这类患者的OLE诊断需结合其他临床资料。结论视觉症状是OLE的典型特征，其发作间期和发作期EEG均有特异的表现。Objective To investigate the characteristics of video electroencephalogram （VEEG） in patients with occipital lobe epilepsy （OLE） to improve the clinical diagnostic rate of OLE. Methods Twenty-five patients with OLE were collected in our hospital from June 2013 to February 2017 and received VEEG monitoring in our epilepsy center. Their clinical symptoms and VEEG characteristics were retrospectively analyzed. Results Nineteen patients （76.00%） had visual auras based on previous history, five （38.46%） had visual auras during VEEG monitoring. Three patients had epileptic discharge confined to occipital lobe and two had epileptic discharge confined to posterior temporal lobe in interictal phase, while 20 had epileptic discharge involved more than one lobe of the brain. In ictal phase, 8 had clear discharge origin or earliest evolution in occipital lobe. Five showed abnormal EEG in the other brain areas, which needed other clinical information for diagnosing OLE. Conclusions The visual aura is typical characteristic of OLE, and there are specific manifestations of EEG in both inter-ictal phase and ietal phase.

关 键 词：枕叶癫痫 视频脑电图 症状学 

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