动态脑电图对热性惊厥患儿脑功能预后评估的价值

Significance of ambulatory electroencephalogram in evaluating the brain function prognosis of children with febrile convulsion

目的:探讨热性惊厥患儿动态脑电图(ambulatoryelectroencephalography,AEEG)监测的脑电图异常率与热性惊厥复发、日后癫痫发作的关系,对远期预后进行评估。方法:1999-01/2002-12新乡医学院第二附属医院脑电监测室,癫痫研究室入组的168例热性惊厥患儿进行24h动态脑电图(24h-AEEG)分析。结果:低热组(体温<38℃)和高热组(体温>39℃)AEEG异常率分别为57%和18%,两者间差异有显著性(P<0.01);年龄≤3岁和5～6岁AEEG异常率分别为23%和56%,两者间差异有显著性意义(P<0.01);首次发作和发作6次以上异常率分别为17%和58%,两者间差异亦有显著性意义(P<0.01)。结论:热性惊厥患儿AEEG阳性率与体温、年龄和发作次数、惊厥持续时间有密切关系。对低热发作、大龄发作及发作次数较多、惊厥持续时间长的患儿定期进行AEEG跟踪监测,对评估及判断疗效和预后有重要意义。

AIM: To study the relationship of abnormal rate of electroencephalogram (EEG) monitored by ambulatory EEG(AEEG) with relapse of febrile convulsion and later febrile seizure, and evaluate the long-term prognosis. METHODS: The 24-hour AEEG of 168 children with febrile convulsion, who were treated in the seizure research room under AEEG monitoring in the Second Affiliated Hospital of Xinxiang Medical College from January 1999 to December 2002, were analyzed. RESULTS: The abnormal rates of AEEG were significantly different between the hypopyrexia group (body temperature < 38 ℃, 57%) and hyperpyrexia group (body temperature > 39 ℃, 18%) (P< 0.01); between children ≤3 years old (23%) and children aged 5 to 6 years (56%) (P< 0.01); also between children with the first seizure (17%) and those with seizure for more than 6 times (58%) (P< 0.01). CONCLUSION: The abnormal rate of AEEG of children with febrile convulsion is closely related with their body temperature, age and times of seizure. Regular follow-up and monitoring of AEEG to the children with hypopyrexia, older and more seizures is of important significance for the instruction of treatment, judge of efficacy and prognosis.