视频脑电图和影像学检查对继发性癫痫患儿的诊断价值研究

Diagnostic Value of Video EEG and Imaging Examination for Children with Secondary Epilepsy

目的:研究视频脑电图(V-EEG)和影像学检查对继发性癫痫患儿的诊断价值。方法:选取从2014年3月到2017年4月在我院接受诊治的癫痫患儿168例纳入本次研究。分别对所有患儿实施V-EEG和核磁共振成像(MRI)诊断,比较两种方式的诊断价值。结果:168例患儿中,V-EEG监测到154例有异常的脑电信号,其中120例有痫样放电,V-EEG显示痫样放电分布在左侧和右侧导联的比例较双侧导联明显更高(P<0.05),MRI检测结果显示,140例患儿有颅内有关结构的病变亦或是发育异常,28例未发现异常。168例患儿中,发作类型为单纯部分型者72例,占比最高,为42.86%;主要病因中,颅内感染的发作类型以全身型为主,占11.31%。脑梗塞的发作类型以单纯部分型为主,占8.33%。颅内软化灶的发作类型以复杂部分型为主,占6.55%。颅内肿瘤的发作类型以单纯部分型为主,占6.55%。MRI定位主要在单侧,其中左侧占38.10%,右侧占29.76%;而经V-EEG监测显示异常放电154例,占91.67%,其中颅内感染和脑梗塞以及颅内肿瘤和颅内软化灶的阳性检出比例最高,分别为24.40%,13.10%,11.90%和10.71%。V-EEG诊断灵敏度和特异度均明显高于MRI(P<0.05)。结论:V-EEG较MRI对继发性癫痫患儿的诊断价值更高,能够更加准确地提供诊断结果数据,值得在临床诊治过程中给予推广和应用。

Objective： To study the diagnostic value of video EEG （V-EEG） and imaging examination for children with secondary epilepsy. Methods： A total of 168 children with epilepsy, who were treated in First Hospital of Qinhuangdao from March 2014 to April 2017, were selected in this study. V-EGG and magnetic resonance imaging （MRI） diagnosis were performed in all children respectively, and the diagnostic value of the two methods was compared. Results： Among the 168 patients, abnormal EEG signals were detected in 154 patients （120 patients had epileptiform discharges）, V-EEG showed that the distribution of epileptiform discharges in the left and right leads were significantly higher than that in bilateral leads, and the differences were significant （P〈0.05）. MRI test showed that 140 patients had intracranial structural lesions or abnormal development, and 28 patients were not found abnormal. Among the 168 cases, 72 cases were pure partial type, the highest proportion was 42.86%; Among the main causes, the type of intracranial infection was mainly systemic, accounting for 11.31%. The type of cerebral infarction was mainly partial type, accounting for 8.33%. The main types of intracranial softening lesions were complex part, accounting for 6.55%. The type of intracranial tumor was mainly partial type, accounting for 6.55%. The location of MRI was mainly unilateral, in which the left side was 38.10% and the right side was 29.76%. V-EEG monitoring showed abnormal discharge was found in 154 cases, accounting for 91.67%, of which intracranial infection and cerebral infarction, as well as intracranial tumors and intracranial softening of the positive detection rate were the highest, respectively 24.40%, 13.10%, 11.90% and 10.71%. The sensitivity and specificity of V-EEG diagnosis were significantly higher than those of MRI （P〈0.05）. Conclusion： V-EEG is more valuable than MRI in the diagnosis of secondary epilepsy. It can provide more accurate diagnostic data and is worthy of promotion and application in the clinical diagnosis and treatment.