鼻咽癌放疗后放射性脑病患者的脑电图研究

A clinical study of EEG in Nasopharyngeal carcinoma patients with radiation encephalopathy

目的：探讨鼻咽癌患者放射治疗后放射性脑病期的脑电图（EEG）表现。方法：收集中山大学孙逸仙纪念医院自2010年7月～2015年12月收治的186例鼻咽癌放疗后放射性脑病患者资料，总结其临床特点及EEG表现。结果：186例放射性脑病患者中，发现EEG异常者94例（50．5％），其中背景活动异常是最常见的EEG异常类型（83例），如基本节律慢化（59例）、持续性弥漫性慢波活动（8例）、广泛性间断性慢波活动（3例）、广泛性不同步慢波（13例）、其他异常类型还有双侧颞区／额、颞区局限性慢波（5例）、单侧颞区／额、颞区局限性非节律慢波（4例）和痢样放电（2例）等。随访过程中，EEG由正常演变为异常17例，由异常转为正常后又再次演变为异常8例。结论：鼻咽癌放射性脑病患者的EEG异常发现率为50．5％，主要表现为背景活动异常，部分表现为单侧或双侧额、颞区局限性慢波增多，伴有癫痫发作患者的EEG可记录到癫痫样异常放电。

Objective：To investigate the characteristics of EEG in patients with radiation encepha- lopathy （RE） after nasopharyngeal carcinoma（NPC） radiotherapy. Methods：One hundred and eighty-six RE patients after NPC radiotherapy from July 2010 to December 2015 in our hospital, were chosen in the study and their clinical and EEG data were collected and analyzed. Results： Abnormal EEG was a common symptom in RE patients after NPC radiotherapy, with an incidence of 50.5 % （94/186）;Abnormal background activity was the most common type of change （83/94） in EEG, including alpha rhythm down （59/94）, persistent diffused slow activity（8/94）, widespread intermittent slow activity （3/94） and wide- spread asynchrony slow waves （13/94）. Other changes such as focal persistent slow activity in bilateral temple or frontal-temporal （5/94）, lateralized temporal /lateralized frontotemporal slow dysrhythmia （4/94） and epileptiform discharges （2/94） were recorded.. Conclusion：The rate of abnormal EEG in RE patients after NPC radiotherapy is 50.5 %. The abnormal background activity is the most common type of change in EEG. The focal slow waves can be found in some RE patients after NPC radiotherapy and the epileptiform discharges can be recorded in the RE patients with seizures after NPC radiotherapy.