结节性硬化所致婴儿痉挛症发作期脑电局灶或一侧优势现象31例报告

The characteristics of ictal EEG showed in local or lateralization of tuberous sclerosis with infantile spasms（A report about 31 cases）

目的：探讨结节性硬化症（TS）所致婴儿痉挛症患者发作期脑电活动局灶改变及其分布优势侧的特征现象，以及与术后疗效的关系。方法：回顾分析了31例TS术前脑电图定位在发作期呈现的局灶、一侧多灶，或双侧均有病灶而以一侧占优势的脑电图现象，并结合术后随访结果对比分析其差异。结果：局灶性放电（单灶）6例，一侧多灶14例，双侧改变以一侧占优势的11例。经统计学处理，局灶与一侧多灶比较差异有显著意义（P〈0．05）．与两侧均有以一侧占优势相比差异有极显著意义（P〈0．01）。结论：TS所致婴儿痉挛症患者间歇期表现为多灶性弥散放电甚至高度失律，但发作期起源灶相对明确，呈现局灶、一侧多灶或者两侧均有以一侧占优势，给外科干预提供有力的依据，并获得良好疗效，尤其对于发作期局灶改变者效果尤好。

Objective： To investigate the characteristics of ictal EEG and correlation between outcomes after surgery and local or lateralization in ictal EEG of tuberous sclerosis with infantile spasms . Methods： The ictal EEG of 31 pediatric TS patienets with infantile spasms were reviewed. Comparative analysis of local, multiple lobes of unilateral hemisphere and lateralization of epileptiform discharges in the ictal EEG. was made. Results：The reseach showed single locus in 6 patients, multiple loci of unilateral hemisphere in 14 cases and lateralization of epileptiform discharges in li cases. Through statistic analysis. there was difference （P〈0.05） between the local groups and multiple lobes of unilateral hemisphere groups, There were obvious difference （P〈0. 01） between the local groups and lateralization groups. Conclusion： General discharge or hypsarrhythmia is showed in interictal EEG of tuberous sclerosis with infantile spasms , but the ictal EEG is relatively optimistic. Epilepsy surgery in tuberous sclerosis with infantile spasms shows a favourable outcome, especially of local patients .