动态脑电图检查对门诊睡眠障碍患儿鉴别诊断及指导治疗的意义  

The Significance of AEEG in the Differential Diagnosis and Treatment of Children with Sleep Disorders

作　　者：丁婉萍 DING Wanping(Quanzhou Children′s Hospital,Quanzhou 362000,China)

机构地区：[1]泉州市儿童医院,泉州362000

出　　处：《世界睡眠医学杂志》2022年第4期696-698,共3页World Journal of Sleep Medicine

摘　　要：目的:探讨动态脑电图检查在门诊睡眠障碍患儿鉴别诊断及指导治疗中的意义。方法:选取2018年2月至2021年2月在泉州儿童医院门诊收治的睡眠障碍患儿138例进行动态脑电图检查,观察其对疾病诊断的作用。结果:共23例脑电图检出癫痫波,占比16.67%,其中8例于夜间睡眠中发生癫痫波,15例全天皆存在癫痫波。其中有7例患儿在AEEG监测中发作时伴有痫性放电,临床表现包括4例夜惊、3例睡眠肌阵挛,确诊为睡眠癫痫并进行抗癫痫治疗。另外16例患儿虽有癫痫样放电,但临床发作与癫痫样放电不同步或无临床发作,故随访复查。对于脑电图正常的患儿采取随访,全面的心理干预,对发作频繁的患儿在排除癫痫的前提下睡前服用氯硝西泮等镇静药物以提高睡眠质量。结论:24 h动态脑电图可记录在自然睡眠下整个睡眠周期变化,可为睡眠障碍和儿童睡眠期癫痫的鉴别诊断及治疗提供可靠依据,避免误诊与漏诊导致延误病情,值得推行。Objective:To explore the significance of ambulatory electroencephalogram(AEEG)in the differential diagnosis and treatment of children with sleep disorders.Methods:A total of 138 children with sleep disorders in Quanzhou Children′s Hospital from February 2018 to February 2021 were selected for AEEG examination.Its role in disease diagnosis was observed.Results:Epileptic waves were detected in 23 cases of EEG,accounting for 16.67%.Among them,epileptic waves occurred in 8 cases during night sleep,and epileptic waves existed in 15 cases all day.The clinical manifestations included 4 cases of night terrors and 3 cases of sleep myoclonus.They were diagnosed as sleep epilepsy and treated with antiepileptic therapy.The other 16 cases had epileptiform discharges,but the clinical seizures were not synchronized with epileptiform discharges or had no clinical seizures,so they were followed up.For the children with normal EEG,follow-up and comprehensive psychological intervention were taken.For the children with frequent seizures,clonazepam and other sedative drugs were taken before going to bed to improve the quality of sleep.Conclusion:24-hour AEEG can record the changes of the whole sleep cycle under natural sleep,which can provide reliable basis for the differential diagnosis and treatment of sleep disorder and children′s sleep epilepsy,and avoid misdiagnosis and missed diagnosis to delay the disease,which is worth promoting.

关 键 词：睡眠障碍 动态脑电图检查 鉴别诊断 指导治疗 

分 类 号：R338.63[医药卫生—人体生理学] R444[医药卫生—基础医学]