孤独症谱系障碍患儿和非癫痫性智力低下患儿的脑电图分析

EEG analysis of children with autism spectrum disorder and non epileptic mental retardation

目的了解孤独症谱系障碍(autism spectrum disorders,ASD)患儿和非癫痫性智力低下(mental retardation,MR)患儿的脑电图(electroencephalogram,EEG)特征。方法对2014年1月至2015年12月首都儿科研究所附属儿童医院诊治的35例ASD患儿及64例非癫痫性MR患儿的EEG进行回顾性分析。其中ASD患儿35例(男30例、女5例),年龄2.9~7.6岁,平均4.1岁。非癫痫性MR患儿64例(男39例、女25例),年龄2.1~8.0岁,平均3.9岁。结果 ASD患儿中,12例(34.3%)存在EEG痫样异常放电,其中临床有癫痫发作者7例(20%)。非癫痫性MR患儿中,15例(23.4%)存在EEG异常放电。经比较,两组患儿的EEG异常表现有所不同,部分ASD患儿(8.6%)的EEG中可见睡眠中癫痫电持续状态,而非癫痫性MR患儿中有6.3%的病例EEG背景呈慢波活动。结论非癫痫性MR患儿EEG除部分可见背景呈慢波活动,余无特异性改变。EEG在一定程度上客观反映了ASD患儿的脑功能情况,对ASD患儿的干预治疗具有指导意义。

Objective To know the characteristics of （electroencephalogram） EEG in children diagnosed with autism spectrum disorders （autism spectrum disorders, ASD） and children with non epileptic mental retardation（mental retardation, MR）. Method The EEG of 35 children with ASD and 64 cases of non epileptic MR were analyzed retrospectively. 35 children （30 males and 5 females） who were meet the conditions of ASD of DSM-IV, Male and female ratio 6：1, mean age 4.1 years （2.9～7.6 years）. 64 children （39 males and 25 females） with non epileptic mental retardation. Male and female ratio 1.6：1, mean age 3.9 years （2.1～8.0 years）. Result There were 12 cases （34.3%） with epileptiform EEG abnormalities in ASD. 3cases （8.6%） of them demonstrated characteristics of ESES （electrical status epilepticus during sleep） in EEG. Epileptiform EEG abnormalities in other two were located in frontal lobe and temporal lobe （each had one case）. Multifocal spikes were showed in 7 cases（20%）, including frontal lobe, temporal lobe, central part and parietal lobe, 7 cases （20%） of the twelve cases had been seizures in the life. 2. There were 15 cases （23.4%） with epileptiform EEG abnormalities in children with non-epileptic MR. In some children with ASD （8.6%）, ESES can be seen in EEG. The EEG of 6.3% children with non-epileptic MR was slow wave activity. Conclusion There was an obvious difference in the prevalence of male and female between the two groups of children. Future studies with larger samples will help to clarify the associations of epilepsy with symptoms of ASD.