难治性癫痫的24小时脑电监测临床意义

Clinical value of twenty-four hour ambulatory EEG monitoring on refractory epilepsy

目的探讨24h脑电(AEEG)监测对难治性癫痫的临床意义。方法对96例难治性癫痫患者进行连续24hAEEG监测。结果AEEG痫波阳性率为64.29%,与常规EEG的28.21%相比较,差异有极显著意义(P<0.001)。且痫样放电与睡眠密切相关。96例患者中捕获41例(42.71%)临床发作,其中31例确诊为癫痫发作;2例癫痫合并假性发作;3例假性发作;3例睡眠呼吸暂停综合征(SAS);2例癫痫合并SAS。结论24hAEEG携带方便,监测期间自然睡眠不受环境改变的影响,显著提高了临床癫痫发作和痫样放电阳性率,还可作为难治性原因之一SAS的筛查检测,有助于难治性癫痫的诊断和鉴别诊断。

Objective To evaluate the clinical value of twenty-four hour ambulatory EEG(AEEG) monitoring on refractory epilepsy.Methods Continuous AEEG monitoring was performed on 96 patients with refractory epilepsy.Results The positive rate of epileptiform discharges was 64.29%,which had extremely significant difference(P<0.001) compared with a rate of 28.21% of routine EEG,and epileptiform discharges were closely related to sleep.The seizure episodes were captured in 41(42.71%) of the 96 patients,and among them 31 were diagnosed epilepsy;2 were diagnosed epilepsy accompanied by pseudoseizure(PS);3 were diagnosed PS;3 were diagnosed sleep apnea syndrome(SAS);2 were diagnosed epilepsy accompanied by SAS.Conclusion 24h AEEG can significantly increase the positive rate of seizure episodes and epileptiform discharges.It can also be applied as a screen to one of the refractory causes of SAS.So it plays an important role in the diagnosis,differential diagnosis and guide to therapy.