电视-脑电长时间监测在癫痫诊断中的应用及与临床诊断的对比研究

Long Term Video-EEG Monitoring in the Diagnosis of Epilepsy-comparison of the Results with and without Video-EEG Monitoring

目的：研究Video－EEG长时间监测在癫痫诊断中的意义，明确临床诊断中易出现的错误。方法：对临床上124例诊断为癫痫、92例可疑癫痫及33例非癫痫患者行Video－EEG监测，并与临床诊断的结果进行对比。结果：临床诊断为癫痫患者中84.7％记录到临床发作，原诊断为强直一阵挛性发作（GTCS）的仅61．5％（16／26）为真正的GTCS，余均为复杂部分性发作（CPS）或CPS继发泛化；可疑“头痛型癫痫”、“腹痛型癫痫”的40例患者中，仅有1例其头痛与发作密切相关。另有6例有CPS发作．但头痛或腹痛并非癫痫发作表现。结论：Video－EEG对癫痫的诊断、鉴别及分类有重要意义。CPS易被误诊为其它类型发作，特别是GTCS，对两者的鉴别临床上有必要行Video－EEG检查。

To study the clinic significance of Video-EEG monitoring in the diagnosis ofepilepsy and the related disorders. Methods: Long term Video-EEG monitoring was performedin 124 epileptic patients, 92 suspected epileptic patients and 33 patients with paroxysmal disordersexcept for epilepsy. The diagnosis with and without Video-EEG monitoring was compared. Results: Epileptic seizures were recorded in 105 out of the 124 epileptic patients(84. 7% ). In the 26patients who were originally diagnosed as generalized tonic-clonic seizure (GTCS), 10 (39. 5 % )were confirmed to be complex partial seizures(CPS) by Video-EEG monitoring. Four patientswith myoclonic seizures and 1 with atonic seizures could only be found by Video-EEG monitoring. In the 92 suspected epileptic patient 22(24% ) were confirmed to be epilepsy. In the 40 patients who were suspected to be so-call' headache epilepsy' or'abdominal epilepsy',only in 1 patient,the headache was found to be related to epileptic seizures. Other 6 patients were found tohave seizures,but the ictal manifestation were other than headache or adbominalgia. Conclusions:Long term Video-EEG monitoring is important for the diagnosis and classification of epilepsy,especially for the differentiation between GTCS and CPS,and in some suspected epilepsic cases.