伴有癫痫发作的结节性硬化症患者的脑电图特点

EEG features of patients with epileptic seizure secondary to tuberous sclerosis complex

目的分析伴有癫痫发作的结节性硬化症(TSC)患者的脑电图特点。方法总结101例有痫性发作的TSC患者的临床资料,对其发作间期及发作期脑电图进行分析。结果癫痫的发病年龄从10d～28岁不等,3岁以内发病者68人(67%)。101例患者均行24h视频脑电图监测,3例脑电图正常,98例脑电图异常,其中3例存在高幅失律,23例为慢波背景活动,72例背景活动正常或接近正常,但其中11例患者脑电图可见较多慢活动。在有痉挛发作的13例患者中,3例脑电图背景为高幅失律,7例为慢波背景活动。发作间期显示痫样波在双侧均明显者35例,一侧痫样波明显者63例,主要集中在前头部。48例患者监测到发作,监测到的发作最常见为部分性发作(27例),26例可以明确起源,主要集中在额颞叶。结论大多数TSC患者脑电图异常,可见痫样波发放,54%TSC患者通过视频脑电图可以明确痫样波起源,主要在额颞叶,左右两侧无明显差异。

Objective To analyze the EEG features of patients with epileptic seizure secondary to tuberous sclerosis complex （TSC）. Methods We retrospectively reviewed the clinical data of 101 patients with epileptic seizure secondary to TSC and analyzed the interictal and ictal EEG features. Results The onset age of patients ranged from 10 days to 28 years. Sixty -eight patients （67%） experienced the first onset when they were less than 3 years old. Among 101 patients undergoing video - EEG monitoring for 24 hours, 3 patients had normal EEG and 98 patients showed abnormal results. Of 98 patients, 3 cases had hypsarrhythmia and 23 cases showed slow wave background activities. Seventy -two patients had normal or near normal background activities, but I 1 cases showed slower wave activities. Of 13 patients with spasms seizure, 3 cases had hypsarrhythmia and 7 cases showed slow wave background activities. Thirty- five patients exhibited bilateral multifocal epileptiform activity in the interictal EEG. Sixth - three patients were lateral dominance and the epileptiform activity was mainly focused at forehead. The seizure waves were recorded in 48 patients and the most frequent type was partial seizure. The seizure onset foci were indentified by ictal EEG in 26 patients, mainly at frontal and temporal lobe. Conclusion Most TSC patients have abnormal EEG and show epileptiform activity. The localization of seizure onset can be identified in half patients by video - EEG monitoring and mainly concentrated at frontal and temporal lobe. No significant differences exist between the left and the right brain.