婴幼儿屏气发作的临床特点及发作期脑电图与心率特征  

Clinical features of infants with breath-holding spells and the characteristics of electroencephalogram as well as heart rate during the episode

作　　者：罗小青 余晓莉[1] 刘明洋 高晶 李承 江军[1] Luo Xiaoqing;Yu Xiaoli;Liu Mingyang;Gao Jing;Li Cheng;Jiang Jun(Department of Electrophysiology,Wuhan Children′s Hospital,Tongji Medical College,Huazhong University of Science&Technology,Wuhan 430016,China)

机构地区：[1]华中科技大学同济医学院附属武汉儿童医院神经电生理室,武汉430016

出　　处：《中华实用儿科临床杂志》2021年第22期1726-1729,共4页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的研究发作期的脑电、心率特征及临床特点对婴幼儿屏气发作鉴别诊断的意义。方法对2016年11月至2019年12月在华中科技大学同济医学院附属武汉儿童医院确诊屏气发作的14例婴幼儿资料进行回顾性分析。结果14例患儿脑电图检查中共监测到16次屏气发作,3次为轻度(不伴意识丧失),发作期脑电为慢-慢模式,分别持续约(23.3±5.8)s和(16.7±5.8)s。13次为重度(伴意识丧失),意识恢复时间为(16.7±12.3)s,12次发作期脑电为慢-平-慢模式,分别持续约(26.4±8.5)s、(8.0±5.1)s和(84.6±46.6)s;第2个慢波期一般为前头部突出广泛性低频段δ慢波节律开始,持续(6.7±1.5)s后演变为弥漫性慢波活动。16次屏气发作中患儿口唇发绀出现在第1个慢波期,意识丧失多出现在平期。短暂心动过缓7次出现在第2个慢波期,4次出现在第1个慢波期,2次出现在平期。结论婴幼儿轻度屏气发作脑电模式为慢-慢模式,重度多为慢-平-慢模式;第1个慢波期慢波常快速演变,意识丧失多出现在平期,意识恢复时间与平期长短密切相关;重度第2个慢波期多为额极突出广泛性低频δ节律开始,屏气发作常伴短暂心动过缓。Objective To analyze the electroencephalogram(EEG)characteristics,heart rate(HR)changes and clinical characteristics during the episode of breath-holding spells(BHS),thus providing refe-rences for the differential diagnosis of infants with BHS.Methods This was a retrospective single-center analysis involving consecutive 14 infants with HBS admitted in Wuhan Children′s Hospital,Tongji Medical College,Huazhong University of Science&Technology from November 2016 to December 2019.Results A total of 16 episodes of crying-induced BHS were detected in the EEG of 14 infants,of which 3 were mild episodes without loss of consciousness and 13 were severe episodes with loss of consciousness.During the mild episodes,EEG presented a phase with slow-slow mode,and the average duration of each phase was(23.3±5.8)s and(16.7±5.8)s,respectively.In addition,the average recovery time from unconsciousness in 13 severe episodes was(16.7±12.3)s.Among the 13 severe episodes,EEG of 12 episodes presented a phase with slow-flat-slow mode,and the average duration of each phase was(26.4±8.5)s,(8.0±5.1)s and(84.6±46.6)s,respectively.Besides,the second slow wave phase usually started by the generalized delta rhythm with predominance in leads of anterior brain,with the average duration at(6.7±1.5)s.During the 16 episodes of BHS,cyanosis occurred in the first phase of slow wav,and loss of consciousness occurred in the flat phase.Transient bradycardia was observed in the second slow wave phase of 7 episodes,the first slow wave phase of 4 episodes and the flat phase of 2 episodes.Conclusions Typical EEG pattern of in infants with mild BHS is slow-slow mode,and most of them with severe BHS is slow-flat-slow mode.In the first slow wave phase,slow wave always evolves rapidly.The unconsciousness mostly occurs in the flat period,the lasting time of which is closely related to the duration of the flat phase.The generalized delta rhythm with predominance in leads of anterior brain mostly starts in the second slow wave phase.A brief bradycardia oft

关 键 词：屏气发作 发作期脑电图 心动过缓 婴幼儿 

分 类 号：R749.73[医药卫生—神经病学与精神病学]