快速眼球运动期发作的睡眠相关过度运动性癫痫的临床和电生理研究  

Clinical and electrophysiological study of sleep-related hypermotor epilepsy during rapid eye movement sleep

作　　者：陈泽 王晓丽 王则直 张歆博 潘远航 李敏 刘永红 Chen Ze;Wang Xiaoli;Wang Zezhi;Zhang Xinbo;Pan Yuanhang;Li Min;Liu Yonghong(Department of Neurology,Xijing Hospital,the Air Force Military Medical University,Xi′an 710032,China)

机构地区：[1]空军军医大学附属西京医院神经内科,西安710032

出　　处：《中华神经科杂志》2022年第8期819-825,共7页Chinese Journal of Neurology

基　　金：航空医学重大课题(2019ZTB03,2020JSTS21)。

摘　　要：目的探讨快速眼球运动(REM)期发作的睡眠相关过度运动性癫痫的临床和神经电生理特点。方法总结空军军医大学附属西京医院神经内科脑电监测中心2016年1月至2021年8月收治的5例发生于REM期的睡眠相关过度运动性癫痫患者的临床和神经电生理特点,并对患者进行随访。结果5例患者中3例为男性,年龄21~46岁。5例患者共监测到23次发作,22次发生在REM期睡眠,1次发作发生于非REMⅢ期睡眠。每次发作持续30 s至1 min,表现为睡眠中"过度运动性发作",伴或不伴意识障碍,13次发作期脑电图无明显异常,9次发作期有局灶性尖慢波或慢波,10次发作后期有局灶性慢波。结论REM期的过度运动性癫痫发作多起始于觉醒反应,发作间期放电均在清醒和非快速眼球运动睡眠期,需注意与REM期行为障碍进行鉴别。Objective To explore the electro-clinical characteristics of sleep-related hypermotor epilepsy(SHE)in rapid eye movement(REM)stage.Methods Five patients of SHE in REM stage were studied and followed up in the Electroencephalogram Monitoring Center,Department of Neurology,Xijing Hospital,the Air Force Military Medical University,from January 2016 to August 2021.Results Among the 5 patients,there are 3 male patients,aged 21 to 46 years.A total of 23 seizures were monitored in 5 patients,of which 22 occurred in REM sleep and 1 occurred in non-REMⅢsleep.Each attack lasted from 30 seconds to 1 minute,and was manifested as"hyperkinetic attack"during sleep,with or without disturbance of consciousness.There were no obvious abnormalities in electroencephalography during 13 attacks,with the focal sharp slow waves or slow waves during 9 attacks,and the focal slow waves occurrence at the end of the 10 attacks.Conclusion Most of the hypermotor epileptic seizures in REM stage started from awakening reaction,and the interictal discharges occured in waking and non-REM sleep stage,which is necessary to distinguish from the REM sleep behavior disorder.

关 键 词：癫痫 睡眠 快速眼运动 脑电描记术 睡眠相关过度运动性癫痫 

分 类 号：R742.1[医药卫生—神经病学与精神病学]