急性病毒性脑炎所致精神障碍脑电图的诊断价值

The diagnostic value of electroencephalography in patients with mental disorders due to acute viral encephalitis

目的研究脑电图对于急性病毒性脑炎所致精神障碍的辅助诊断价值。方法在入院3天内对临床拟诊为急性病毒性脑炎所致精神障碍的病人分别进行脑电图、头颅CT、磁共振(MRI)检查,其中有48例确诊为病毒性脑炎所致精神障碍,分析病人的头颅CT、磁共振(MRI)以及中度或重度异常脑电图的机率,并进行比较。正常或轻度异常脑电图在一周后进行复查。结果头颅CT的异常率为12．50%(6/48),头颅MRI异常率为33．33%(16/48),中度或重度异常脑电图的发生率为66．67%(16/ 48),采用配对X^2检验比较脑电图与两种影像学方法(头颅CT、MRI)有显著性差异(P＜0．005)；脑电图16例轻度异常者一周后有4例转为中度或重度异常。结论脑电图对急性病毒性脑炎所致精神障碍有重要的辅助诊断意义,比头颅MR等影像学检查有更高的敏感性。另外,脑电图轻度异常不能排除急性病毒性脑炎所致精神障碍。

Objective： To evaluate the diagnostic value of electroencephalography （EEG） assisted in diagnosis of mental disorders due to acute viral encephalitis. Methods： All patients with a paradiagnosis of mental disorders due to acute viral encephalitis underwent EEG, computed tomography （CT） and magnetic resonance imaging（MRI） within 3 days after hospitalization, and 48 patients were finally diagnosed as mental disorders due to acute viral encephalitis. The rate of abnormal findings in CT, MRI and moderate or severe abnormal EEG was analyzed. Cases with normal or mildly abnormal EEG were re - examined after one week. Results：The rate of abnormal CT and MRI is 12.5% （6/48）and 33.3% （16/48）, respectively. Moderately or gravely abnormal findings observed in EEG were 66.7% （ 16/48 ）. Matched - pairs Ki - square analysis was performed to compare the rates and significant differences （ P 〈 0. 005 ） were found. The EEG abnormality of four cases with mild abnormal EEG on admission become moderate or severe after one week. Conclusion：EEG shows important value and high sensitivity in auxiliary diagnosis of mental disorders due to acute viral encephalitis vs MR or CT scans. The diagnosis of viral encephalitis can not be excluded in patients with mildly abnormal EEG at the early stage.