癫痫儿童98例发作间期动态脑电图分析

Study of interictal ambulatory EEG in 98 epileptic children

目的探讨动态脑电图(AEEG)在发作间期儿童癫痫诊疗中的价值。方法 采用康泰CMS4000动态脑电图仪于发作间期24h监测分析98例癫痫儿童并对其AEEG异常率相关因素进行比较分析。结果 AEEG监测异常者84例(85.7%)。84例中有痫样放电者59例(60.2%)[其中48例(49.0%)兼有非特异性异常];仅有非特异性异常者25例(25.5%)。AEEG痫样放电率在不同的发作频率(无发作、<1次/月、≥1次/月)组间比较存在显著差异,发作越频繁,痫样放电阳性率越高(P<0.01)。59例痫样放电者中,出现在清醒期4例(6.8%),出现在睡眠期者27例(45.8%),清醒及睡眠期均出现28例(47.5%),睡眠期与清醒+睡眠期痫样放电检出率高于清醒期(P<0.01)。非特异性异常者73例中,出现在清醒期者5例(6.8%),出现在睡眠期者23例(31.5%),清醒及睡眠中均出现者45例(61.6%),睡眠期与清醒+睡眠期非特异性异常检出率高于清醒期(P<0.01)。治疗后复查的癫痫儿童较新诊断的癫痫儿童痫样放电率明显降低(40.7%vs59.3%,P<0.01)。结论 AEEG能在自然状态下长时间记录患儿清醒、睡眠各种状态的脑电活动,可提高发作间期癫痫儿童痫样放电及非特异性异常检出率,有助于儿童癫痫的临床诊断、疗效评估。

Objective To explore the application value of interictal ambulatory electroencephalogram（AEEG） in children with epilepsy. Methods Using CMS4000 AEEG apparatus,AEEG was performed continuously for 24 hours during interictal seizures in 98 epileptic children,and the factors related to AEEG abnormality rate were analyzed and compared. Results Abnormal AEEG was recorded in 84 cases （85.7%）.Of 84 there was epileptiform discharge in 59 cases （60.2%）,in which nonspecific abnormality together with epileptiform discharge in 48 cases （490%）;and nonspecific abnormality only in 25 cases（25.5%）.In the attack frequencies of episode,less than 1 time once a month and more than or equal to 1 time once a month,the higher the attack frequency was,the higher the positive rate of epileptiform discharge was（P0.01）.Of 59 cases with epileptiform discharge,4 appeared in wakefulness （6.8%）,27 in sleep （45.8%） and 28 in both wakefulness and sleep （47.5 %）.The epileptiform discharge rates in sleep phase and wakefulness phase plus sleep phase were higher than that in wakefulness phase （P0.01）.Of 73 cases with nonspecific abnormality,5 appeared in wakefulness phase（6.8%）,23 in sleep phase （31.5%） and 45 in both wakefulness and sleep phase （61.6%）.The nonspecific abnormality rate in sleep phase and wakefulness phase plus sleep phase were higher than that in wakefulness phase （P0.01）.Compared with newly diagnosed epileptic children,the epileptiform discharge rate in epileptic children checked after treatment decreased significantly （40.7% vs 59.3%,P0.01）. Conclusions AEEG could record the encephaloelectric activities in long time and natural state on wakefulness and sleep,and could elevate the detection rate of epileptiform discharge and nonspecific abnormality,thus it is helpful in clinic diagnosis and efficacy estimation of children epilepsy.