视频脑电图在新生儿癫痫发作中的应用效果研究  

Study on the effect of video EEG in neonatal seizures

作　　者：吕晓敏 

机构地区：[1]广东省鹤山市人民医院,广东鹤山529700

出　　处：《中国医药科学》2018年第2期17-20,共4页China Medicine And Pharmacy

基　　金：广东省江门市卫生和计划生育局科学技术研究项目(16A101)

摘　　要：目的探究视频脑电图(VEEG)在新生儿癫痫发作中的应用效果。方法选择2016年7月～2017年11月我院小儿内科50例新生儿惊厥发作患儿,均进行VEEG监测,并分析其检查结果。结果 (1)50例新生儿中,15例患儿临床发作与痫样放电同步出现,可诊断为癫痫发作;另有7例患儿为发作期无同步痫样放电,诊断为非癫痫发作。(2)15例癫痫发作患儿结合病史、临床症状以及VEGG表现可明确其癫痫发作类型,分别为2例局部强直性发作,2例肌阵挛性发作,11例局部阵挛性发作。(3)33例患儿通过VEEG监测到痫样放电,其中睡眠期痫样放电频率63.64%,显著高于清醒期27.27%;(4)33例痫样放电患儿其起源部位多为局灶放电87.88%,且主要以颞区为主。另外,通过探讨痫样放电检出率与病因关系发现,脑器质性病变痫样放电异常率最高75.76%。(5)治疗后3个月随访发现,微小型、单灶阵挛发作患儿其预后90.63%要好于其他惊厥发作类型的患儿,且惊厥性发作持续时间在48h以上、发作次数≥3次的患儿其后遗症发生几率更高,差异有统计学意义(P<0.05)。结论在新生儿惊厥发作诊治中,应用VEEG不仅能够提高癫痫的临床诊断及分型的准确率,有效鉴别非癫痫发作性疾病,还可用于早期新生儿癫痫发作预后判断的一种有效检查手段。Objective To explore the effect of VEEG in neonatal seizures. Methods A total of 50 cases with neonatal seizure from July 2016 to November 2017 in pediatric internal medicine of our hospital were selected as the subjects. All cases were monitored by VEEG and the results were analyzed. Results （1）In 50 cases,15 cases of clinical manifestations and epilepsy discharge occurred in same time,who could be diagnosed as epileptic seizures;Another 7 cases had no epilepsy discharge during clinical manifestations,who were diagnosed as non-epileptic seizures.（2） Fifteen epileptic children with epilepsy could be clearly determined the type of epilepsy by history,clinical symptoms and VEGG manifestations,2 cases of local tonic seizures,2 of myoclonic seizures, and 11 of local clonic seizures. （3）Epileptiform discharges were monitored in 33 children by VEEG,and the epileptiform discharge frequency in sleep stage was 63.64%,which was significantly higher than the awake period 27.27%.（4）In 33 cases of epileptiform discharges,the origin was mostly focal discharge 87.88%,mainly in temporal region.In addition,the abnormal rate of epileptiform discharges in brain organic lesions was the highest 75.76% by exploring the relationship between the detection rate of epileptiform discharges and the etiology.（5）The follow-up of 3 months after treatment showed that the prognosis of children with minor,single focal clonic seizures 90.63% was better than that of other types of convulsions,and sequelae were more likely to occur in cases with convulsive seizure duration in more than 48h,and attacking more than 3 times（P 〈 0.05）. Conclusion In the diagnosis and treatment of neonatal seizures,the application of VEEG can not only improve the accuracy of clinical diagnosis of epilepsy and the type,to identify the non-epileptic seizures,and can be used for early neonatal seizures is an effective means to check the prognosis.

关 键 词：视频脑电图 新生儿癫痫 非癫痫发作 预后 

分 类 号：R722.1[医药卫生—儿科]