缺氧后肌阵挛5例临床与脑电图分析

Clinical evaluation and EEG analysis in five patients with posthypoxic myoclonus

目的通过对5例缺氧后肌阵挛(posthypoxicmyoclonus,PHM)患者临床资料及脑电图检查结果的分析,结合治疗与转归,探讨PHM的发病机制、临床表现、神经电生理特点、治疗及预后。方法收集5例PHM患者临床资料,分析其临床表现、脑电图特点、治疗及转归。结果 5例患者均为院内心肺复苏成功后患者,均在复苏成功后出现反复发作的肌阵挛,同步脑电图显示痫样放电时有时无,常规抗癫痫治疗效果不完全肯定。结论 PHM临床表现与肌阵挛癫痫相似,但电生理检查无特异性。丙戊酸、氯硝西泮、拉莫三嗪、左乙拉西坦等抗癫痫药物可试用于临床治疗,且主张早期联合用药。

Objective To investigate the pathogenesis of PHM, its clinical manifestations, electroneurophysiological characteristics, and its therapy and prognosis by analyzing clinical data and EEG data in 5 patients with posthypoxic myoclonus in conjunction with their therapy and therapeutic results. Methods The clinical data from 5 patients with PHM were collected. The clinical manifestations, EEG charateristics, treatments and prognosis were analyzed. Results After successful cardiopulmonary resuscitation, five inpatients presented with repeated episodes of myoclonus. Mean- while there was presence or absece of myocolnus-associated spikes displays from time to time in the EEG. The effects of conventional anti-epileptic drugs for posthypoxic myoclonus are not indeterminate. Conclusion Clinical manifesta- tions of PHM are similar to myoclonic epileptic siezures, but there are no specific electrophysiological findings. Treat- ment with valproic acid, clonazepam, lamotrigine and other anti-epileptic drugs may improve the patient＇s clinical out- come. It is advocated that a combination of anti-epileptic frugs is used as earlier as possible.