癫痫性痉挛的电-临床特征与结构性病变的关系  

Relationship between electrical-clinical features of epileptic spasm and structural lesions

作　　者：陈新 江卫 沙飞[1] CHEN Xin;JIANG Wei;SHA Fei(Center of Electrophysiology,Children's Hospital Affiliated to Nanjing Medical University,Nanjing 210008,China)

机构地区：[1]南京医科大学附属儿童医院神经电生理中心,210008

出　　处：《临床神经病学杂志》2022年第1期45-48,共4页Journal of Clinical Neurology

摘　　要：目的探讨癫痫性痉挛(ES)的电-临床特征与结构性病变的关系。方法收集144例有ES发作患儿的临床资料,并进行视频EEG(VEEG)检查。结果<1岁患儿的发作间期背景为典型高度失律比率最高(56.6%),其后典型高度失律比率随着年龄增加逐渐减低。不同年龄组患儿背景无典型高度失律的比率差异有统计学意义(χ^(2)=29.718,P<0.001)。不同痉挛类型患儿结构性异常率差异有统计学意义(χ^(2)=15.612,P<0.001);不同发作类型患儿的结构性异常率无统计学意义(χ^(2)=4.218,P=0.239)。发作间期VEEG局灶性放电、发作期不对称放电及不对称性痉挛的患儿影像检查结构性异常率分别高于发作间期VEEG为非局灶性放电、发作期放电及痉挛发作为对称的患儿(χ^(2)=27.985,P<0.001;χ^(2)=14.902,P<0.001;χ^(2)=4.981,P<0.05)。结论随着年龄增加,典型高度失律比例逐渐减低。晚发性ES、发作间期局灶性放电、发作期不对称放电或不对称的痉挛可能与脑内局灶性病变相关,可考虑手术治疗。Objective To analyse the relationship between electrical-clinical features of epileptic spasm(ES)and structural lesions.Methods The clinical data of 144 children with ES attack were collected,and video EEG(VEEG)was performed.Results The incidence of hypsarrhythmia background in interictal period was the highest(56.6%)in children under 1 year old,and then the incidence gradually decreased with age.There was significant difference in the incidence of no hypsarrhythmia background of children between the different age groups(χ^(2)=29.718,P<0.001).There was statistically significant difference in structural lesions rate among children with different spasm types(χ^(2)=15.612,P<0.001);and there was no statistically significant difference in structural lesions rate among children with different seizure types(χ^(2)=4.218,P=0.239).The structural abnormality rates of imaging examination in focal discharge during interictal,asymmetric discharge and asymmetric spasm during ictal were significantly higher than those in non-focal discharge during intericta,symmetric discharge and spasm during ictal(χ^(2)=27.985,P<0.001;χ^(2)=14.902,P<0.001;χ^(2)=4.981,P<0.05).Conclusions As age increases,the rate of classic hypsarrhythmia decreases.Children who have late-onset epileptic spasms,focal discharge during interictal,or asymmetric discharge and asymmetric spasm during ictal may have structural lesions,and peration treatment can be considered.

关 键 词：癫痫性痉挛 视频EEG 结构性病变 

分 类 号：R742.1[医药卫生—神经病学与精神病学]