长程视频脑电监测在癫痫诊断中的应用效果分析

Application effect analysis of long-term VEEG monitoring in the diagnosis of epilepsy

目的探讨长程视频脑电监测（VEEG）应用在癫痫诊断中的临床效果及实际意义,评价其临床应用价值。方法选取2013年11月~2015年12月在本院行长程视频脑电图监测的174例患者作为研究对象,对患者2、6、12、24 h的脑电图监测结果进行分析,了解临床发作和癫痫样异常放电的关联。结果 174患者中,共监测到115例出现临床发作现象,105例诊断为癫痫,56例无法明确诊断是否属于癫痫,另13例诊断为非癫痫患者。59例无临床发作的患者中,发作间期异常放电39例,癫痫不能排除;余下20例始终无异常放电,不能诊断是否为癫痫。在174例患者中,144例异常放电,其中12例是在清醒期,50例在睡眠期,还有82例是清醒期、睡眠期均同时出现异常放电。此外,105例确诊患者中,发作前均有异常脑电图改变,同时根据监测时相发现2 h时相和6 h时相的临床发作率比较,差异有统计学意义（P〈0.05）。6 h时相和12 h时相的临床发作率比较,差异有统计学意义（P〈0.05）。6 h时相和24 h时相的临床发作率比较,差异无统计学意义（P〉0.05）。四个时相的异常放电率比较,差异无统计学意义（P〉0.05）。结论相比传统的脑电图（EEG）监测,VEEG优势更加显著,能够显著提高癫痫样异常放电检出率和临床发作检出率,帮助临床医师确诊癫痫、明确分型,值得临床推广应用。

Objective To explore the clinical effect and significance of application of long-term video electroencephalogram（VEEG） monitoring in the diagnosis of epilepsy.Methods 174 patients adopting the long-term VEEG from November 2013 to December 2015 in our hospital were selected as the research group,the VEEG monitoring result at the time phase of 2,6,12,24 hours were analyzed.The correlation of clinical attacks with abnormal epileptiform discharge was analyzed.Results For 174 patients,there were 115 cases with attacks,105 patients were confirmed with epilepsy,56 cases were not confirmed,13 cases with confirmed without epilepsy.For 59 cases without attacks,there were 39 cases of abnormal discharge during the process,20 cases without abnormal discharge were not confirmed.For 174 patients,there were 144 cases of abnormal discharge including 12 cases in the lucid interval,50 cases in the sleep stages and 82 cases in the lucid interval and sleep stages.For 105 confirmed cases,there were abnormal EEG before attacks of epilepsy,there was significant difference in the rate of clinical attacks between the time phase of 2 hours and 6 hours（P〈0.05）.There was significant difference in the rate of clinical attacks between the time phase of 6 hours and 12 hours（P〈0.05）.There was no significant difference in the rate of clinical attacks between the time phase of 6 hours and 24 hours（P〈0.05）.There was no significant difference in the rate of rate of abnormal discharge at four time phases（P〈0.05）.Conclusion Compared with the conventional EEG monitoring,VEEG can improve the detection rate of abnormal epileptiform discharge and clinical attacks,which can make a definite diagnosis and make a clear staging of epilepsy,it is worthy of clinical promotion and application.