500例不明原因智力障碍或发育迟缓患儿的视频脑电图分析  

Video Electroencephalogram Analysis of 500 Patients with Unexplained Intellectual Disability or Developmental Delay

作　　者：高志杰[1] 张平平 王昕[1] 张乐 郎鹏飞 涂瑶 陈倩[1] GAO Zhijie;ZHANG Pingping;WANG Xin(Department of Neurology,Affiliated Children's Hospital of Capital Institute of Pediatrics,Beijing 100020,China)

机构地区：[1]首都儿科研究所附属儿童医院神经内科,北京100020

出　　处：《医学研究杂志》2023年第10期136-140,共5页Journal of Medical Research

基　　金：首都卫生发展科研专项(2022-2Z-2104)。

摘　　要：目的观察500例不明原因智力障碍或发育迟缓患儿中脑电图异常的发生率,总结智力障碍或发育迟缓患儿发作间期痫样放电的特点,探讨发作间期痫样放电与智力障碍或发育迟缓程度、年龄、性别的关系。方法对2019年7月~2021年10月首都儿科研究所附属儿童医院神经内科门诊诊断的500例不明原因智力障碍或发育迟缓患儿的视频脑电图进行回顾性分析,总结脑电图表现。结果500例不明原因智力障碍或发育迟缓患儿中男患儿381例(76.2%),女患儿119例(23.8%),患儿年龄3个月~15岁8个月。轻度智力障碍或发育迟缓患儿289例(57.8%),中度智力障碍或发育迟缓患儿164例(32.8%),重度智力障碍或发育迟缓患儿47例(9.4%)。143例患儿出现脑电图异常(28.6%),其中114例患儿(22.8%)有痫样放电伴或不伴背景异常,29例患儿(5.8%)仅表现为背景异常。局灶性发作间期痫样放电最常见,占12.6%(63/500),多灶性和(或)广泛性占9%(45/500);局灶性发作间期痫样放电中以Rolandic区最多见,占6.8%(34/500)。智力障碍程度与发作间期痫样放电呈显著正相关(r=0.167,P<0.001)。发作间期痫样放电异常与年龄呈显著正相关(r=0.114,P=0.011)。女患儿发作间期痫样放电发生率显著高于男患儿,差异有统计学意义(χ^(2)=3.879,P=0.049)。结论脑电图异常率及发作间期痫样放电率与智力障碍或发育迟缓程度、患儿年龄、性别等方面存在相关性,应加强对伴有发作间期痫样放电的智力障碍或发育迟缓患儿的随访,必要时早期干预;应重视通过视频脑电图结合病史对智力障碍或发育迟缓患儿进行非惊厥性癫痫病的筛查,以早期诊断治疗。Objective To observe the incidence of electroencephalogram(EEG)abnormalities in 500 children with unexplained mental retardation or developmental delay.The characteristics of interictal epileptiform discharges were summarized and the relationships between EEG changes and the degree of mental retardation or developmental delay,age,and gender were also explored.Methods The video EEG of 500 children with unexplained mental retardation or developmental delay,diagnosed in the Department of Neurology of the Affiliated Children's Hospital of Capital Pediatrics Research from July 2019 to October 2021,were retrospectively analyzed,and the EEG performance was summarized.Results Among 500 children with unexplained mental retardation or developmental delay,381(76.2%)were males and 119(23.8%)were females,aged from 3 months to 15 years and 8 months.A total of 289 cases of mild mental retardation or developmental delay(57.8%),164 cases of moderate mental retardation or developmental delay(32.8%),47 cases of severe mental retardation or developmental delay(9.4%)were identified.EEG abnormalities were found in 143 patients(28.6%),114 patients(22.8%)had epileptiform discharges with or without background abnormality,and 29 patients(5.8%)showed only background abnormality.The most common epileptiform discharges were focal interictal discharges(63/500,12.6%).Multifocal and/or extensive discharges were 9%(45/500).The Rolandic area was the most common area of epileptiform discharge in the interval of focal seizure,accounting for 6.8%(34/500).There was a significant positive correlation between the degree of intellectual impairment and interictal epileptiform discharges(r=0.167,P<0.001).The interictal epileptiform discharge were positively correlated with age(r=0.114,P=0.011).The incidence of interictal epileptiform discharges in girls were significantly higher than those in boys(χ2=3.879,P=0.049).Conclusion The interictal epileptiform discharge rate are related to the degree of mental retardation or developmental delay,children's age,a

关 键 词：精神发育迟滞 发育障碍 儿童 视频脑电图 

分 类 号：R741[医药卫生—神经病学与精神病学]