脑电图监测对儿童病毒性脑炎急性期病情及预后的评估意义

The value of electroencephalography monitoring in the assessment of acute phase and the prognosis of children with viral encephalitis

目的探讨脑电图监测对病毒性脑炎患儿病情及预后的评估意义。方法回顾性分析57例病毒性脑炎患儿的临床资料,主要包括临床表现、头颅影像学、急性及恢复期脑电图。结果本组患儿男性(40例)多于女性(17例),7、8、10月份高发。患儿均伴有发热。急性期头颅CT均未见异常,89.5%的患儿同期行MRI检查,6例异常。急性期脑电图异常主要为全导联广泛弥漫性高波幅θ波或δ波;恢复期脑电图异常主要为受累部位的棘慢综合波和棘波。结论病毒性脑炎症状多样,均有发热表现。急性期头颅MRI检查比头颅CT检查灵敏度高。脑电图背景越慢,病情越重,脑电图异常持续时间越长,预后越差。脑电图监测对病毒性脑炎急性期病情及预后评估有重要指导意义。

Objective To investigate the value of electroencephalography monitoring in the assessment of acute phase and the prognosis of children with viral encephalitis. Methods The clinical data of 57 children with viral en-cephalitis were analyzed retrospectively, including clinical manifestations, cranial images, EEG. Results More patients were boys, and the viral encephalitis occurred more frequently in July, August, and October. All children had a fever. In the acute phase, head CT examinations of all cases were not obviously abnormal. Fifty-one patients（89.5%） had brain MRI examinations during the same period, brain MRI examinations of 6 patients were abnormal. In the acute phase, the EEG showed wildly distributed high θ wave or δ wave. In the sequelae phase, EEG showed the slow wave in the affected brain. Conclusion Fever is an essential symptom of viral encephalitis. In acute phase, the sensitivity of brain MRI is higher than CT. The longer duration of the abnormal EEG lasts, the worse the prognosis is. EEG monitoring is a guidance for viral encephalitis assessment in acute phase and prognosis.