长程视频脑电监测在诊断癫痫中的应用分析

Diagnostic value analysis of Video-EEG monitoring in epilepsy

目的:分析和研究癫痫患者视频脑电图表现,评价视频脑电监测技术在癫痫的诊断价值。方法:对2008年6月-2010年11月我科接收的248例发作性疾病患者视频脑电图2、6、12、24 h监测结果进行回顾分析。分析临床发作与癫痫样异常放电之间的关系、异常放电出现的时相,癫痫分型与异常放电的关系,临床发作前脑电图的改变以及临床发作间期和发作期异常脑电图的不同表现,监测时程与临床发作率、异常放电率之间的关系。结果:248例发作性患者监测到145例临床发作,其中113例确诊为癫痫,18例为非癫痫,14例暂无诊断结论;178例异常放电,其中14例出现在清醒期,55例出现在睡眠期,76例同时出现在清醒期和睡眠期;确诊的113例癫痫患者发作前脑电图有异常改变;不同监测时程临床发作率2 h和6 h有差别,6 h和12 h有差别,6 h和24 h无差别,异常放电率各个时程无区别。结论:视频脑电图可提高癫痫样异常放电检出率和临床发作检出率,有助于癫痫的诊断、分型,适合在临床推广使用。

Objective：To evaluate the diagnostic value of Video-EEG monitoring in epilepsy by analyzing and studying the manifestations of the disease.Methods：Video-EEG monitoring was performed continuously 2,6,12 h and 24 h in 248 patients with paroxysmal events who were accepted between June 2008 and November 2010.The relationship between seizures and abnormal discharge,the phases when abnormal discharge appeared and the relationship between epilepsy classification and abnormal discharge were analyzed.EEG changes before seizures and different EEG findings in both ictal and interictal periods,the relationship between EEG monitoring time-history and clinical attack rate and the abnormal discharge rate were also observed.Results：The characteristic events were captured in 145 of the 248 patients.Out of the 145 patients,113 had clinical events accompanied with epileptiform discharge and were diagnosed as epilepsy,18 as non-epilepsy patients,and 14 had no diagnosis results.Among the 178 patients with abnormal discharge,14 cases appeared in sober period,55 cases appeared in sleep period,and 76 cases appeared in both sober period and sleep period.The 113 patients diagnosed as epilepsy had anomalous changes before seizure.There were different clinical attack rates in monitoring time-histories between 2 h and 6 h,6 h and 12 h,and no differences between 6 h and 24 h.No different abnormal discharge rate was detected among the time-histo ries.Conclusion：Video-EEG can help to improve detection rate of abnormal discharge and epilepsy seizures,and conduce to the clinical diagnosis,classification of epilepsy,which is suitable for clinical promotion.