癫痫患者癫痫发作后不同时段及昼夜发作脑电图改变  

Monitoring time and episode time of epileptiform discharges by long-term video EEG in epilepsy patients

作　　者：段尉梅 艾明达 龚云兴 杨珺 张林明[1] 陈玲[1] Duan Weimei;Ai Mingda;Gong Yunxing;Yang Jun;Zhang Linming;Chen Ling(Deparment of Neuroogy,theFirstAfiliated HospitalofKunming Medical University,Yunnan 653200,Chi)

机构地区：[1]昆明医科大学第一附属医院,云南653200

出　　处：《脑与神经疾病杂志》2022年第7期435-439,共5页Journal of Brain and Nervous Diseases

基　　金：云南省神经系统疾病诊疗中心应用基础研究(ZX2019-03-05);云南省医学学科后备人才项目(H-2018058);国家自然科学基金(82060252,81760243);云南省基础研究计划面上项目(2018FB115,2019FE001(-217))。

摘　　要：目的 对癫痫(EP)患者末次EP发作后不同时间段进行视频脑电图(VEEG)监测及EP患者不同昼夜发作与脑电图(EEG)异常率之间的关系。方法 本文采集171例临床诊断的EP患者,按末次EP发作后1d内、2~3d、4~7d和8~30d进行VEEG监测的四个时间段分组,分析EP发作后不同时间进行EEG监测对EEG异常率的影响;同时按癫痫发病时间(昼或夜)进行分组,分析发病时间对EP患者EP发作后EEG异常率的影响。结果①在171例患者中,末次癫痫发作后1d内、2~3d、4~7d和8~30d进行VEEG监测的患者分别为22例、24例、49例和76例,四组患者的EEG异常率分别为59.1%(13/22)、70.8%(17/24)、63.3%(31/49)和55.3%(42/76),采用多个率比较的趋势性卡方检验进行组间比较显示差异无统计学意义(χ^(2)=0.749,P=0.387);但EEG异常率呈现出先上升后下降趋势,在EP发作后2~3d内进行VEEG监测获得的EEG异常率最高;②在171例患者中,末次EP发作发生在白天的患者84例,发生在夜间的患者87例,其EEG异常率分别为52.4%(44/84)和67.8%(59/87),差异有统计学意义(χ^(2)=4.251,P=0.039)。结论 EP患者EP发作后2~3d VEEG异常率最高;夜间发作的EP患者EEG异常率明显高于白天发作的患者。Objective Video electroencephalogram(VEEG) was monitored at different time points after epileptic seizures in last epileptic seizure and episode time in epileptic seizure to observe the abnormal rate of EEG.Mehods According to the included inclusion and exclusion criteria,171 clinically diagnosed epilepsy patients who underwent EEG monitoring from the department of neurology,First Affiliated Hospital of Kunming Medical University from August 2017 to September 2018,were selected according to whether there was any seizure before this epileptic seizure(EP).Four time points of VEEG monitoring were performed within 1 day after the onset,2 to 3 days,4 to 7 days,and 8 to 30 days.At the same time,according to episode time(day or night),the abnormal rate of EEG was also analyzed.Results ① Among the 171 patients,after last(EP),22 patients,24 patients,49 patients,and 76 patients underwent VEEG monitoring at within 1 day,2 to 3 days,4 to 7 days,and 8 to 30 days,respectively.The abnormal rates of EEG in the four groups was 59.1%(13/22),70.8%(17/24),63.3%(31/49),and 55.3%(42/76).Comparisons among groups using trended chi-square tests with multiple rates showed no statistically significant differences.(χ^(2)=0.749,P=0.387);However,it was found that the EEG abnormal rate showed a first increase and then decreased regardless of the pre-existing predisposition.The EEG abnormal rate obtained by VEEG monitoring within 2-3 days after seizure was the highest;② Among the 171 patients,84 patients had seizures during the day and 87 patients occurred at night.The abnormal rates of EEG were 52.4%(44/84) and 67.8%(59/87),respectively.There was no statistical significance(χ^(2)=4.251,P=0.039).Conclusion Patients had the highest EEG abnormality rate within 2 to 3 days after seizure.The abnormal rate of EEG in epileptic seizures at night was significantly higher than that at daytime episodes.

关 键 词：癫痫 癫痫发作 视频脑电图 

分 类 号：R742.1[医药卫生—神经病学与精神病学]