儿童期常见非癫癎性发作的临床及脑电图特点

THE CLINICAL AND ELETROENCEPHALOGRAM CHARACTERISTICS OF COMMON NON-EPILEPTIC SEIZURES IN CHILDREN

目的:总结儿童期常见非癫癎性发作(Non-Epilepsy Seizure,NES)的临床及脑电图特点,以提高临床医生的诊断水平,减少误诊;并探讨视频脑电图(Video-EEG,VEEG)在诊断儿童NES中的应用价值。方法:回顾性分析2008年1月至2010年12月在我院行VEEG后诊断为NES的328例患儿的临床及脑电图资料。结果:良性新生儿肌阵挛或颤抖18例、良性非癫癎性婴儿痉挛14例、非癫癎性强直发作39例、情感性交叉擦腿19例、屏气发作9例、睡眠障碍108例、抽动障碍43例、偏头痛18例、晕厥23例、癔症性发作4例、其他33例。126例患儿监测到临床发作,且同期脑电图均未记录到癎性发放。17例癫癎患儿合并NES,21例NES合并发作间期癫癎样波发放。结论:儿童期常见各种类型NES,通过详细询问病史获得可靠的发作期症状,并辅以脑电图检查可做出正确诊断。视频脑电图是明确儿童NES的类型,鉴别NES和ES的最可靠的检查方法。

Objective： To summarize the clinical and electroencephalogram （ EEG ） characteristics common non-epileptic seizures （ NES ） in children for improving the diagnostic rate and reducing the misdiagnosis and study the value of video- EEG for the diagnosis of children＇s NES. Methods： The clinical and EEG data of 328 children with NES diagnosed by VEEG in our hospital from Jan.2008 to Dec.2010 were analyzed retrospectively .Results： The common types of NES in children included benign neonatal sleep myoclonus or jitterness （ 18 cases ） , benign nonepileptic infantile spasms （ 14 cases ） , nonepileptic tonic seizure （ 39 cases ） , masturbation （ 19 cases ） , breath-holding attacks （ 9 cases ） , sleep disorders （ 108 cases ） ,tic disorders （ 43 cases ）, migraine （ 18 eases ） ,syncope （ 23 cases ）, hysteria attacks （ 4 cases ） , other seizures （ 33 cases ） . 126 cases of clinical seizure were recorded without epileptiform discharges in ictal period. 17 cases of NES complicated with epilepsy, 21 cases of NES complicated epileptiform discharges in interictal period.Conclusions： There are various NES in children, doctors are able to diagnose accurately by detailed history of seizure and EEG. VEEG is a reliable way for diagnosing and differentiating NES and ES.