癫痫患儿脑电图与心电图改变的临床分析(附104例报告)

Clinical Analysis of EEG and ECG in Epileptic Children(A Report of 104 cases)

目的探讨癫痫患儿癫痫发作与发作间期动态脑电图和心电图的变化特点。方法回顾性分析我院104例行24 h动态脑电图与心电图同步监测癫痫患儿的临床资料。结果本组动态心电图出现异常34例,占32.7%;出现以颞部为主的异常脑电波64例,动态心电图异常率为37.5%,心电图异常表现方式最多,室性早搏、心律不齐、传导阻滞、室上性心动过速均可在同一患儿动态心电图中见到占79.2%;出现以额叶为主的异常脑电波22例,动态心电图异常率为22.7%,多表现为窦性心动过速;出现以顶、枕叶为主的异常脑电波10例,动态心电图异常率为20.0%,出现心律不齐1例;多灶性或广泛性放电8例,动态心电图异常率为37.5%,心律不齐2例。动态心电图出现异常的34例中,动态脑电图主要表现为慢波增多,或双侧颞区、额区、中央区和顶区出现大量中高电位局灶性棘(或尖)波、(多)棘(或尖)慢复合波,或双侧颞部局限性(或节律性)中高波幅的慢波θ或δ波。监测期间动态心电图异常的34例癫痫患儿,发作与发作间期的动态心电图无明显改变者占38.2%,发作前后伴窦性心动过速或心律失常占61.8%。结论癫痫患儿癫痫发作期动态心电图发生异常的概率较发作间期高,与癫痫发作部位及动态脑电图波形异常存在一定联系。

Objective To investigate the change of EEG and ECG during epileptic paroxysm and arrhythmia in epileptic children.Methods The clinical data of 104 epileptic children who received 24 h active EEG and EEC monitoring in our hospital were retrospectively analyzed.Results The active EEG showed 34 abnormal cases（32.7%）;temple abnormal brain wave appeared in 64 cases,and the abnormal rate of active EEG was 37.5%.EEG in the epileptic children had the most manifestations,such as premature ventricualr contraction,arrhythmias,conduction block,supraventricular tachycardia,all of which could be seen in the same child with the rate of 79.2%;22 cases were found to have unusual brain wave primarily on temporal lobe,and the abnormal rate of dynamic EEG was 22.7%,with sinus tachycardia as the most common form;10 cases were found to have abnormal brain activity primarily on occipital lobe,with the abnormal rate of dynamic EEG of 20% and 1 case of anisorhythmia;There were 8 cases of multi-lesion or extensive discharge,with the abnormal rate of dynamic EEG of 37.5% and 1 case of anisorhythmia;For 34 patients who had abnormal dynamic EEG,their ECG manifestations included increasing slow wave,either massive appearance of high electric potential bureau spike,sharp,multiple spike and composite wave on the two-sided of emporal,frontal,central and parietal region,or loc or rhythmic middle amplitude θorδwave on both sides of emporal region.During the monitoring period,among 34 patients who had abnormal dynamic EEG,38.2% showed no clear change in EEG when the epilepsy occurred,61.8% had sinus tachycardia and arrhythmia either before or after the strike.Conclusion The abnormal rate of dynamic ECG seems to be higher during the occurrences of symptoms than that during the intermediate stage,which is related to the area of epileptic paroxysm and the presence of unusual activity in dynamic EEG.