振幅整合脑电图对儿童重症病毒性脑炎继发非惊厥型癫持续状态的诊断意义

Estimating the Value of a EEG in Monitoring the Children with Nonconvulsive Status Epilepticus Secondary to Severe Viral Encephalitis

目的研究振幅整合脑电图(aEEG)对于重症病毒性脑炎继发非惊厥型癫持续状态(NCSE)诊断的敏感度和特异度,探讨视频脑电图(VEEG)与aEEG结合在诊断NCSE中的临床意义。方法回顾性分析26例临床诊断为重症病毒性脑炎继发NCSE(NCSE组,经临床及脑电图判定符合NCSE)患儿的临床资料,另设对照组(22例,临床上存在意识障碍、自动症等表现,经判定不符合NCSE)。对两组病例进行脑电图检查及相关辅助检查。通过统计学分析对各项参数进行差异性分析。结果NCSE组在发作期及缓解期aEEG波幅差异有显著性(P<0.001),而对照组差异无显著性。以VEEG作为诊断标准,aEEG对于NCSE诊断的敏感度为100%,特异度为90.1%。结论对于重症病毒性脑炎继发NCSE的诊断,aEEG具有高敏感度、变化直观,易于快速解读等优势,对于尽早诊断及干预治疗有着重要意义。

Aim To demonstrate amplitude-integrated EEG（a EEG） as a novel diagnostic instrument for children with severe viral encephalitis who consequently developed nonconvulsive status epilepticus（NCSE）. Methods Twenty six cases with NCSE and other 22 cases as matched group from Mar 2015 to Dec 2016 were selected. Each case was monitored by vedio electroencephalogram（VEEG） and a EEG were recorded simultaneously. The data of VEEG and a EEG methods were compared statistically. Results In NCSE group, there was significant difference at amplitude between epileptic seizure and interictal epilepsy（P〈0.001）. On the contrary, no differences were observed in the matched group. VEEG was used as the standard of diagnosis, the sensitivity of a EEG was 100% in diagnosis of NCSE, and the specificity of a EEG was 90.1%. Conclusion a EEG showed better sensitivity as well as specificity than VEEGin identifying NCSE patients. Better operationality and less training course are also encouraging the application for clinical work.