儿童睡眠行为障碍24 h脑电图监测分析

Analysis of 24 hour EEG monitoring in children with sleep-behavioral disorders

目的:观察睡眠行为障碍患儿的脑电图(EEG)改变,探讨其对临床诊断及鉴别诊断的价值.方法:对50例睡眠行为障碍患儿进行24 h EEG监测.结果:EEG中癎样波10例,检出率为12.5%.其中9例癎样波有局灶或局灶性偏胜.拟诊梦游症20例中,癎样波检出6例,检出率为30%;拟诊夜惊28例中,4例有癎样波,检出率为14.3%;拟诊梦魇2例,均为正常EEG.在描记中8例有临床发作,其中梦游及夜惊7例,均发生在NREM Ⅲ～Ⅳ期, EEG显示阵发性高幅δ、θ、α混合波型;梦魇1例发生在REM期, EEG显示觉醒波型.结论:儿童睡眠行为障碍中有一定数量患儿实际为癫癎, EEG在临床诊断及鉴别诊断方面有一定价值.

Objective:To observe the variation of EEG of the children with sleep-behavioral disorders and explore the value of EEG in clinical and differential diagnosis .Methods:Fifty children with sleep-behavioral disorders received EEG monitoring for 24 hours .Results:Epileptiform activities were found among 10 children and the detection rate was 12.5%. Nine of them were localized or predominantly localized. Six of 20 children suspected of having sleepwalking were found to have epileptiform activities and the detection rate was 30%.Four of 28 children suspected of having night terrors were found to have epileptiform activities and the detection rate was 4.3%. Two children suspected of having nightmare had normal EEG. Recordings demonstrated that 8 children had clinical attacks, and 7 of them suffered from sleepwalking or night terror .All these symptoms occurred during Ⅲ~Ⅳstages of NREM and there appeared paroxysmal, high-amplitude,mixed-frequency wave pattern including δ、θ and α waves. One case of nightmare attacks occurred during REM, which recordings presented awake waves.Conclusions:A certain number of children with sleep-behavioral disorders actually were patients with epilepsy. Twenty-four hour EEG monitoring has a definite value in clinical and differential diagnosis.