100例癫痫患者脑电图与磁共振分析

An analysis of EEG and MRI in 100 epileptic patients

目的:观察脑电图和头颅MRI在确诊癫痫及其病因诊治方面的应用,探讨痫性放电与结构异常之间的关系。方法:选100例癫痫患者,均作REEG、AEEG、头颅CT和MRI检查。比较四种检查方法的阳性率和异常病灶的分布。应用卡方检验,比较痫性放电与结构异常之间的关系。结果;REEG痫性放电35例(35%),AEEG76例(76%),比REEG多提供了41%的异常信息。CT发现颅内异常25例(25%),MRI发现异常58例(58%)。在EEG单侧局灶放电的53例中,MRI异常42例,18例双侧半球放电中,MRI异常5例,经x2检验,局灶痫性放电者MRI异常率显著高于双侧半球痫性放电者(P<0.01);MRI正常的42例患者中EEG痫性放电26例,异常率为61.9%,MRI发现结构异常的58例患者中,EEG异常放电50例,异常率为86.2%,经x2检验发现MRI结构异常患者,痫性放电出现率高(P<0.01)。结沦:AEEG是确诊癫痫、指导治疗的有利依据;MRI可作为癫痫患者病因诊断的首选影像检查。痫性放电与结构异常有一定关系。

Objective： To analyse the, roleo of EEG and MRI inthe diagnosis of epilepsy and its causes, and discuss the relationship between epileptic discharges and morphological abnormalities. Methods： One hundred epileptic patients were studied by REEG, AEEG, CT scanning and MRI examination. The relationship between the epileptic discharges and the neuroradioligical lesions was analysed by chi-square test. Results.. REEG found epileptic discharge in thirty-five patients while AEEG found in seventy-six patients. AEEG provided 41% more abnormal information than that of REEG. There were twenty-five cases of structural lesions by CT scanning and fifty-eight cases of structural lesions by MRI. Forty-two lesions were found by MRI in the fifty-eight patients who had focal epileptic discharge. There only five lesions among the eighteen patients whose epileptic discharge was bilateral. The abnormal ratio of focal epileptic discharge was higher than that of bilateral epileptic discharge（P〈0.01）. There twenty-six（61. 9%） patients with epileptic discharge among those with normal MRI scanning, compared to fifty（86.2%） patients with epileptic discharge among those with abnormal MRI scanning. The positive ratio of epileptic discharge was higher than that of abnormal MRI scanning（P〈0.01）. Conclusions： AEEG is a useful tool in making diagnosis and in guiding therapy. MRI should be the first choice in finding epileptic structure abnormalities. There is correlation between epileptic discharge and structural abnormality.