长程视频脑电监测在癫痫规范诊疗中的应用

The application of long range video EEG monitoring in the diagnosis and treatment of epilepsy

目的:观察长程视频脑电监测在癫痫规范诊疗中的应用效果。方法:选取经常规脑电图监测拟诊为癫痫的106例患者的临床资料作为研究对象。通过长程视频脑电监测,观察脑电图异常率、可疑脑电图异常率、脑电图大致正常率、不同监测时相的痫样放电发生率、确定癫痫样发作,不同监测时程与临床发作、异常痫样放电发生率的关系等。结果:106例患者脑电图异常的占67.9%,可疑脑电图异常的占11.3%,脑电图大致正常的占20.8%;单纯睡眠期痫样放电率明显高于睡眠期+清醒期以及单纯清醒期(P<0.05)。监测时程2 h的临床发作率最高,明显高于监测6 h、12h以及24 h(P<0.05);监测12 h的临床发作率明显高于6 h和24 h(P<0.05);不同监测时程的异常痫样放电发生率没有明显差异(P>0.05)。结论:视频脑电图可提高癫痫样异常放电检出率和临床发作检出率,有助于癫痫的诊断、分型,适合在临床推广使用。

Objective To observe the effect of long term video EEG monitoring in the diagnosis and treatment of epilepsy.Method The 106 enrolled patients were diagnosed as epilepsy by routing EEG monitor in our hospital.All subjects received long term video EEG monitor,observing and counting the rate of abnormal EEG,the rate of suspected abnormal EEG,the rate of roughly normal EEG,the rate of epileptiform discharges in different time phases and the relationship between different monitoring time course and clinical seizures and abnormal epileptiform discharge.Results The rate of abnormal EEG accounted for 67.9%,the rate of suspected abnormal EEG was 11.3%,the rate of roughly normal EEG was 20.8%;the epileptiform discharges during sleep was significantly higher than that during sleeping ＋ awaking phases and awaking phase（ P〈0.05）.The clinical attack rate was significantly higher in the 2 h of monitoring time course than that of 6 h,12 h and 24 h monitoring time courses（ P〈0.05）;the clinical attack rate was higher in the 12 h of monitoring time course than that of 6 h and 24 h（ P〈0.05）.The rates of abnormal epileptiform discharge had no significant difference among the different monitoring time coures（ P〈0.05）.Conclusion Video EEG can improve the detection rate of epileptiform discharges and clinical seizures,which is helpful for the diagnosis and classification of epilepsy.