长程脑电图在癫诊断与鉴别诊断中的价值

Value of long-term EEG in diagnosis and differential diagnosis of epilepsy

目的探讨长程脑电图(EEG)在癫疒间诊断与鉴别诊断中的价值。方法对265例癫疒间患者(癫疒间组)和206例非癫疒间患者(非癫疒间组)进行长程EEG记录,并进行分析。结果癫疒间组清醒EEG异常率为54.72%,睡眠EEG异常率为89.81%,两者差异有极显著性(P<0.001);非癫疒间组清醒EEG异常率为7.28%,睡眠EEG异常率为10.68%,两者差异无显著性(P>0.05)。癫疒间组患者睡眠时额叶和颞叶的癫疒间性放电阳性率最高,分别为20.38%和24.15%,与清醒状态阳性率(11.32%和11.70%)相比差异有极显著性(均P<0.01)。结论长程EEG在癫疒间的诊断和鉴别诊断中有重要意义,特别是多个周期的睡眠诱导可明显提高癫疒间性放电的阳性率,并对致癫疒间灶的定位提供重要参考。

Objective To evaluate the value of long-term EEG in diagnosis and differential diagnosis of epilepsy. Methods The long-term EEG records of 265 cases of epilepsy and 206 cases without epilepsy were analyzed retrospectively. Results The abnormality rate of epileptic group during awake and sleep was 54.72% and 89.81%, respectively, there was a distinguished difference between them （P 〈0. 001 ）. While the abnormality rate was 7.28% during awake and 10.68% during sleep in non-epileptic group. The difference was not significantly （P 〉0. 05 ）. Further more, the discharge rates at frontal lobe and temporal lobe during sleep were the highest （20. 38% and 24. 15%, respectively）, which were obviously different from those during awake （11.32% and 11.70%, respectively ） （ P 〈 0. 001 ）. Conclusions Long-term EEG has great importance in the diagnosis and differential diagnosis of epilepsy, especially it increases the detective rate of discharge by several cycles of sleep derivation may. This method also provides important reference for the allocation of epileptic focus.