6岁以内低龄儿童非癫痫性发作性事件的临床及脑电图特征  

Clinical and Electroencephalogram Characteristics of Nonepileptic Seizures Events in Low-aged Children Younger than 6 Years

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12期104-108,共5页Journal of Medical Research

基　　金：首都卫生发展科研专项项目(2022-2Z-2104)。

摘　　要：目的分析6岁以内低龄儿童非癫痫性发作性事件的临床及脑电图特征。方法回顾性分析2019年7月~2021年7月首都儿科研究所附属儿童医院收治的6岁以内低龄儿童以发作性症状为主诉并进行视频脑电图监测的患儿的病例资料。根据患者的临床症状、体征,结合视频脑电图监测结果,由两名神经内科医生明确诊断。总结非癫痫性发作的临床特征,分析视频脑电图的特征。结果共433例视频脑电图记录到非癫痫性发作,其中生理性非癫痫性发作398例(91.9%),心因性非癫痫性发作35例(8.1%)。24例患儿检测到发作间期癫痫样放电,占5.5%(24/433),以Rolandic区放电15例(3.5%)最为常见。运动性发作最为常见,共392例(90.5%);非运动性发作共41例(9.5%)。非癫痫性发作中,非癫痫性肌阵挛发作最为常见。生理性非癫痫性发作男性多于女性,心因性非癫痫性发作女性多于男性,组间性别构成比比较,差异有统计学意义(χ^(2)=12.513,P<0.001)。1~3岁组心因性非癫痫性发作占比显著高于0~1岁组(χ^(2)=8.713,P=0.003),但与3~6岁组比较,差异无统计学意义(χ^(2)=5.253,P=0.022)。结论6岁以内低龄儿童非癫痫性发作脑电图多为正常,发作间期癫痫样放电率低,无发作期特征性脑电图改变,发作间期背景脑电图可作为诊断参考。6岁以内低龄儿童非癫痫性发作临床特征复杂多样,以生理性非癫痫发作为主,生理性非癫痫性发作以运动性发作为主要发作形式,以非癫痫性肌阵挛发作最为常见;1~3岁儿童心因性非癫痫性发作相对多见。Objective To analyze the clinical and electroencephalogram(EEG)characteristics of nonepileptic seizures in low aged children younger than 6 years.Methods The case data of low-aged children younger than 6 years who were admitted to the Affiliated Children′s Hospital of Capital Institute of Pediatrics from July 2019 to July 2021 with episodic symptoms as the main complaint and underwent video EEG monitoring were retrospectively analyzed.According to the patient′s clinical symptoms and signs,combined with the video EEG monitoring results,the diagnosis was made by two neurologists.To summarize the clinical characteristics of nonepileptic seizures,and analyze the characteristics of video EEG.Results A total of 433 cases of nonepileptic seizures were recorded by video EEG,including 398 cases(91.9%)of physiological nonepileptic seizures and 35 cases(8.1%)of psychogenic nonepileptic seizures.Interparoxysmal epileptic discharges were detected in 24 cases(5.5%,24/433),and 15 cases(3.5%)in Rolandic region were the most common.The motor seizures were most common(392 cases,90.5%).There were 41 cases(9.5%)of non-motor seizures.Nonepileptic myoclonic seizures were the most common in nonepileptic seizures.The number of men with physiological nonepileptic seizures was more than that of women,and the number of women with psychogenic nonepileptic seizures was more than that of men.There was significant difference in gender composition between the groups(χ^(2)=12.513,P<0.001).The proportion of psychogenic nonepileptic seizures in the 1-3 years group was significantly higher than that in the 0-1 year group(χ^(2)=8.713,P=0.003),but there was no statistical difference compared with the 3-6 years group(χ^(2)=5.253,P=0.022).Conclusion The EEG of nonepileptic seizures in low-aged children younger than 6 years is mostly normal,the epileptic discharge rate is low in the interictal period,and there is no characteristic EEG change in the interseizure period,the interictal background EEG can be used as a diagnostic reference.The clinica

关 键 词：发作性疾病 非癫痫性发作 儿童 视频脑电图 

分 类 号：R741[医药卫生—神经病学与精神病学]