200例抽动障碍患儿脑电图回顾性研究

A retrospective study of EEG manifestations in 200 children with tic disorder

目的观察抽动障碍(TD)患儿的脑电图表现及其相关影响因素。方法将200例TD患儿按脑电图检查结果分为正常脑电图组、界限性脑电图组及异常脑电图组。观察200例TD患儿脑电图表现,分别比较3组发病年龄、性别、TD分型、耶鲁综合抽动严重程度量表(YGTSS)评分及中医证候分布情况。结果 200例TD患儿中,正常脑电图176例(88.0%),界限性脑电图6例(3.0%),异常脑电图18例(9.0%)。界限性脑电图与异常脑电图共24例,占12.0%。6例界限性脑电图者表现为α波欠规则、节律较差等。18例异常脑电图者中,15例表现为慢波增多、θ波频率增高等非特异性异常,占总数200例的7.5%,3例脑电图结果出现可疑散在棘慢波、尖波等特异性异常,占总数200例的1.5%。3组TD患儿发病年龄、性别、TD分型、YGTSS评分及中医证候分布比较差异均无统计学意义(P>0.05)。结论部分TD患儿脑电图存在非特异性异常。脑电图可作为排除性检查手段,如果TD患儿未出现痫样放电等异常,一般无需定期复查脑电图,但针对脑电图存在显著异常或病程较长的患儿,有必要进一步复查脑电图来明确患儿的脑功能状态。

Objective To observe the electroencephalogram(EEG) manifestations of children with tic disorder(TD) and its related factors. Methods According to the results of EEG, 200 children with TD were assigned to the normal EEG group, borderline EEG group and abnormal EEG group. The EEG manifestations of 200 children with TD were observed, and the age, gender, TD type, YGTSS score and TCM syndrome distribution of three groups were compared. Results Among 200 children with TD, 176 cases(88.0%) had normal EEG, 6 cases(3.0%) had borderline EEG and 18 cases(9.0%) had abnormal EEG. There were 24 cases with boundary EEG and abnormal EEG, accounting for 12.0%. 6 cases showed irregular α wave with poor rhythm. Among 18 cases with abnormal EEG, 15 cases showed non-specific abnormality such as increased slow waves and increased frequency of θ wave, accounting for 7.5% of the 200 cases. 3 cases showed suspicious scattered spike-and-slow wave complex and sharp wave, accounting for 1.5% of the 200 cases. There was no significant difference in age, gender, TD type, YGTSS score or TCM syndrome distribution among the three groups(P>0.05). Conclusions Some children with TD had nonspecific abnormal EEG. EEG can be used as an exclusive examination method. If there is no abnormality such as epileptiform discharge in children with TD, it is not necessary to review EEG regularly. However, for children with significantly abnormal EEG or a long course of disease, it is necessary to further review EEG to determine their brain function.