幕上肿瘤患者动态脑电图中出现双侧同步节律性慢波与继发癫痫的关系  

The association between the presence of bilateral synchronous rhythmic slow wave in ambulatory EEG recordings and secondary epilepsy in patients with supratentorial tumor

作　　者：方升[1] 钟光宇[1] 但炜[2] 

机构地区：[1]成都市第三人民医院功能神经病区,成都610031 [2]重庆医科大学附属第一医院神经外科,重庆400016

出　　处：《保健医学研究与实践》2017年第5期37-41,共5页Health Medicine Research and Practice

基　　金：重庆市卫生局重点课题(2012-1-008);成都市卫生局青年课题(2013078)

摘　　要：目的探讨幕上肿瘤患者动态脑电图中出现双侧同步节律性慢波与继发癫痫的关系。方法本研究选取重庆医科大学附属第一医院及成都市第三人民医院2008年1月-2015年7月收治的255例幕上肿瘤患者为研究对象。采用16导动态脑电图记录仪采集患者动态脑电图资料,每例患者均描记24h。分析患者动态脑电图中出现双侧同步节律性慢波的情况与患者癫痫发作、肿瘤所在部位的关系。结果 255例患者中,有145例患者动态脑电图中出现双侧同步节律性慢波,其中51例患者有癫痫发作史,110例患者动态脑电图中未出现双侧同步节律性慢波,其中26例患者有癫痫发作史,经χ2检验,P<0.05,表明患者动态脑电图中出现双侧同步节律性慢波与患者癫痫发生有关。患者肿瘤占位情况:额叶占位者79例,颞叶占位者68例,顶叶占位者42例,枕叶占位者8例,前颅窝底占位者22例,中颅窝底占位者6例(鞍区占位者5例,蝶骨嵴占位者1例),脑中线部位占位者26例(侧脑室内占位者3例,侧脑室旁占位者8例,胼胝体压部占位者4例,矢状窦旁占位者11例),多发占位者4例。不同部位肿瘤患者动态脑电图中双侧同步节律性慢波出现率的差异有统计学意义(P<0.05)。不同部位肿瘤患者癫痫发生率的差异有统计学意义(P<0.05)。结论双侧同步节律性慢波不是幕上肿瘤患者继发癫痫的特有波型,但出现双侧同步节律性慢波的患者比未出现此种波的患者更易继发癫痫。Objective To investigate the association between the presence of bilateral synchronous rhythmic slow wave in ambulatory EEG recordings and the development of secondary epilepsy in patients with supratentorial tumor.Methods A total of 255 patients with supratentorial tumor admitted into the First Affiliated Hospital of Chongqing Medical University or the Third People′s Hospital of Chengdu from January 2008 to July 2015 were included in this study.All patients received 24 hEEG monitoring using a 16-channel ambulatory EEG system.The potential association between the presence of bilateral synchronous rhythmic slow wave in ambulatory EEG recordings and the development of epileptic seizures or the tumor location was analyzed.Results Bilateral synchronous rhythmic slow wave was detected in the ambulatory EEG recordings of 145 patients,51 of whom had a history of epileptic seizures;such a wave was not observed in the other 110 patients,26 of whom had a history of epileptic seizures.According to the results of a chi-squared test,the presence of bilateral synchronous rhythmic slow wave in ambulatory EEG recordings was significantly associated with the development of epileptic seizures（P〈0.05）.In terms of the tumor location,79 patients had a tumor located in the frontal lobe,68 in the temporal lobe,42 in the parietal lobe,8 in the occipital lobe,22 in the anterior cranial fossa,6 in the middle cranial fossa（5 in the sellar region,and 1 on the sphenoid ridge）,26 had midline tumors（3 in the lateral ventricle,8 in the periventricular area,4 in the genu of the corpus callosum,and 11 in the parasagittal area）,and the other 4 had tumors in multiple locations.The detection rate of bilateral synchronous rhythmic slow wave in ambulatory EEG recordings varied significantly among patients with tumor（s）in different locations（P〈0.05）.The incidence of secondary epilepsy also varied significantly among patients with tumor（s）in different locations（P〈0.05）.Conclusion Bilateral synchronous rhythmic slow wa

关 键 词：双侧同步节律性慢波 幕上肿瘤 癫痫 动态脑电图 

分 类 号：R739.41[医药卫生—肿瘤]