视频脑电图监测对小儿癫痫的诊断价值探讨

Exploration of diagnostic value of Video-EEG monitoring in children epilepsy

目的探讨视频脑电图(VEEG)对小儿癫痫的诊断价值。方法对102例临床拟诊为癫痫患儿进行4～8h视频脑电图监测,其中包括清醒、睡眠期记录;分析临床发作和异常放电的关系,异常放电出现的时相。结果监测到临床发作并且同步异常放电者23例,仅发作间期癫痫样放电者53例,两者共76例(76/102,74.51%)结合病史确定为癫痫,其中局灶性52例(52/76,68.42%),睡眠中出现55例(55/76,72.37%)。10例(10/102,9.80%)临床发作但无同步异常放电,判定为非癫性发作。结论视频脑电图可提高儿童癫痫诊断的正确率,有助于癫痫的定位,部分剥夺睡眠有助于癫痫样放电的检出率。

Objective To explore the diagnostic value of Video electroencephalogram （Video-EEG） monitoring in children epilepsy. Methods Video-EEG monitoring under the state of awaking and sleeping were performed 4-8 hr in 102 epilepsy children. We analysed the relation between clinical seizures and abnormal discharge, observed the phase when abnaomal discharge appeared. Results abnormal discharge were captured in 76 patients （76/102,74.51%）, and among the 76 patients, 23 patients had clinical seizures accompanied synchronous abnormal discharge, 53 patients just had interictal epileptiform discharge only, all of them were diagnosed epilepsy according to Video-EEG and case history.Among of them, 52 were focal （52/76,68.42%）, and 55 were found in sleeping （55/76,72.37%）. 10 patients （10/102,9.80%）were just clinical seizures unaccompanied synchronous abnormal discharge, and these cases were defined nonepileptic seizures. Conclusions Video-EEG can improve epilepsy diagnostic rate, is favourable to localization of epilepsy. Partly sleep deprivation is an effective method to increase detection of epileptiform discharge.