流行性脑脊髓膜炎脑电图的特点以及意义(附59例分析)

The Characteristic and Value of Electroencephalogram for Epidemic Cerebrospinal Meningitis(59 cases)

目的探讨流行性脑脊髓膜炎(Epidemic Cerebrospinal Meningitis,DCSM)的脑电图(electroen-cephalogram,EEG)改变的特点以及意义。方法回顾性分析了59例DCSM的EEG资料,调查了患者临床不同病情以及不同病程状态与EEG异常的关系。结果59例患者中,4例EEG未发现异常(6.8%),55例EEG异常(93.2%),其中轻度异常18例(18/55,32.7%),中度异常24例(24/55,43.6%),重度异常13例(13/55,23.6%)。经x2检验,双侧头痛的EEG异常程度比单侧头痛高(t=3.45,P=0.025);出现球后视神经水肿的EEG发生率高于无合并球后视神经水肿者(t=3.15,P=0.045)。经精确Bayes检验法比较,随着意识障碍程度的加深,EEG异常趋于明显(t=2.78,P=0.040)。脑脊液异常的EEG异常发生率明显高于脑脊液正常者(t=3.01,P=0.025)。治疗后,随着症状好转与体征的消失,EEG趋于正常,经回归方程比较,相关系数P=0.82,P=0.030。结论EEG检查能用于可作为判断DCSM病情严重程度、动态了解病情转归以及评价治疗效果。

Objective To explore the characteristic and value of electroencephalogram （EEG） for epidemic cerebrospinal meningitis（DCSM）. Methods There were 59 cases of DCSM whose data of EEG were analysed retrospectively about the relationship between the abnormality of EEG and the clinical pathogenetic condition and the course of DCSM. Results There were 4 cases whose EEG were normal （4/59, 6.8%） and 55 cases whose EEG were abnormal （55/59, 93.2%）, among whom there were 18 cases （18/55, 32.7%） of low-grade, 24 cases （24/55, 43.6%） of midrange and 13 cases （13/55, 23.6%） of high-grade. By x^2 test, the EEG was much more abnormal when bilateral headache than unilateral headache （t=3.45, P=0.025）, and the ratio was higher when complicated with optic disc edema than without optic disc edema （t=3.15, P=0.045）. By precise Bayes test, the more of the consdious disturbance, the more of the abnormality of EEG （t=2.78, P=0.040）, and the ratio of abnormality about EEG was higher when cerebrospinal fluid was abnormal than that normal 0=3.01, P=0.025）. Following the disappeaxance of symptom, the EEG became normal, and by regression equation test, the correlation coefficient was 0.82 and P value was 0.030. Conclusions EEG can be used to judge the severity of DCSM, following the turnover of pathogenetic condition and evaluate the therapeutic efficacy.