婴儿痉挛的视频脑电图特征分析

A study of clinical and video-EEG characteristics of infantile spasms.

目的 分析婴儿痉挛的临床发作特征 ,探讨视频脑电图 (Video EEG)检查在诊断中的作用。方法 对 1999年 1月至 2 0 0 3年 10月中国医科大学深圳儿童医院收治的 6 1例婴儿痉挛患儿采用Video EEG监测 ,观察婴儿痉挛发作的临床表现和发作期以及发作间期的脑电图特征。结果 共监测到 87次痉挛发作 ,可见 4种表现类型 ,主要为屈肌型痉挛。发作时脑电图可见 7种形式 ,主要为快波节律或高波幅单个尖慢复合波 (或仅慢波 ) ,后随电压抑制。 13次发作仅出现 1种形式脑电图改变。 74次出现 2种或 2种以上形式的脑电图改变 ,最多可在一次发作中见到 4种形式脑电图改变。发作间期的脑电图背景活动均失去正常结构 ,以典型的高峰节律紊乱和变异型的高峰节律紊乱为主。在同一个患儿的监测中 ,可同时见到多种形式脑电图改变。结论 婴儿痉挛独特的轴性痉挛可表现为多种形式和合并其它形式发作。EEG在发作期和发作间期有多种形式 ,高峰节律紊乱是大多数婴儿痉挛的特征性脑电图形。Video

Objective To explore clinical characteristics of infantile spasms and the roles of video EEG.Methods We studied clinical features and characteristics of video EEG in interictal phase and ictal phase in 61 patients with infantile spasms.Results 87 episodes of spasms were recorded,which were clinically divided into four subtypes,mainly flexor subtype.There were seven EEG patterns in ictal phase,the common patterns being fast wave bursts and high voltage single sharp and slow wave complex(or only slow wave) followed by electrodecremental discharge.Among eighty seven episodes,thirteen spasms appeared with one single EEG pattern,seventy four appeared with two or more mixed patterns and could be with up to four patterns in one episode.EEGs were abnormal in interictal phases.Typical hypsarrhythmia and its variants were predominant.The EEG background activities lost normal structures in interictal phase.Multiple patterns of EEGs were recorded in one patient.Conclusion Axial spasms in infantile spasms can manifest multiple types and are accompanied by other seizure types.EEGs in ictal and interictal phases show various patterns.Hypsarrhythmia and its variants are characteristic interictal EEG patterns in most patients.Video EEG can provide strong evidences in the diagnosis and differential diagnosis of infantile spasms.