难治性癫痫持续状态患者的脑电图特征

Features of EEG patterns in patients with refractory status epilepticus

目的 探究难治性癫痫持续状态（RSE）患者的脑电图（EEG）特征.方法 将60例全面惊厥性癫痫持续状态（GCSE）患者根据抗癫痫药物（AEDs）疗效分为RSE和非难治性癫痫持续状态（NRSE）,比较两组患者EEG模式的差异.结果 所有患者中,与NRSE组比较,RSE组患者发作期EEG呈持续性放电比例更高,差异具有统计学意义（OR=5.44,95%CI=1.24~23.96,P=0.04）.50例EGG呈间歇性演变的患者中,与NRSE组比较,RSE组患者发作间歇期EEG呈周期性放电与痫样放电的比例较高,差异有统计学意义（OR=29.75,4.12;95%CI=3.19~277.32,1.09~15.58;P〈0.05）;而RSE组患者发作后EEG为正常模式的比例较低,差异具有统计学意义（OR=0.11,95%CI=0.01~0.91,P=0.04）.结论 GCSE患者如EEG出现持续性放电、周期性放电、发作间期痫样放电,应引起临床的高度重视,给以强化抗惊厥治疗.

Objective To analyze the features of electroencephalography （EEG） patterns in patients with refractory status epilepticus（RSE）. Methods Sixty patients with Generalized convulsive status epilepti-cus （GCSE） were divided into RSE group and non-RSE （NRSE） group according to the effect of anti-epileptic drugs （AEDs）. EEG data was compared between two groups. Results In all patients, compared with NRSE group, patients in RSE group showed significantly higher proportion of persistent ictal activity in EEG （OR=5.44, 95%CI=1.24-23.96,P=0.04）. In 50 patients with intermittent change of EEG, compared with NRSE group, pa-tients in RSE group showed significantly higher proportion of periodic discharges and interictal epileptiform dis-charges （OR=29.75,4.12; 95%CI=3.19-277.32, 1.09-15.58;P〈0.05）, and lower proportion of normalization after ictal （OR=0.11,95%CI=0.01-0.91,P=0.04）. Conclusions Attention should be paid to EEG patterns of persistent ictal activity, occurrence of periodic discharges and interictal epileptiform discharges for the treatment of GCSE.