小儿癫痫视频脑电图监测最佳时间及不同发作类型检出率

Optimal time for video-based electroencephalogram monitoring and the detection rate of different seizure types in children with epilepsy

目的:探究小儿癫痫视频脑电图监测最佳时间以及不同发作类型检出率情况。方法:选取2017年1月至2020年1月张家口市第一医院儿科收治的400例癫痫患儿,按脑电图检测时间随机分为8组,每组50例。对所有患儿行视频脑电图监测,监测时间段分别为1、2、4、6、8、10、12、24 h,记录不同时间段癫痫患儿的脑电波阳性率和脑电图特征,分析不同发作类型的脑电图特征及阳性检出情况。结果:不同监测时间组总体阳性率差异无统计学意义(P<0.05);随着监测时间的增加,阳性率逐渐升高,在监测时间10和12 h时阳性检出率为98.00%,监测6 h与监测10 h和12 h阳性检出率比较差异无统计学意义(P>0.05);在观测到的360例阳性患儿中,有64例为全身强直阵挛发作,28例阵挛性发作,21例强直性发作,48例失神发作,29例肌阵挛性发作,34例失张力发作,43例单纯部分性发作,92例复杂部分性发作,不同发作类型的临床表现和脑电图特征不同;全面性发作在监测6 h时检出率最高,局限性发作在监测12 h时检出率最高。结论:视频脑电图监测癫痫患儿具有较好的实用价值,脑电图特征可用于判断患儿的发作类型,监测时间12 h的阳性率为100%,监测6 h时的监测性价比最高,可基本满足临床诊断需求。

Objective:To explore the optimal time for video-based electroencephalogram(EEG)monitoring and the detection rate of different seizure types in children with epilepsy.Methods:A total of 400 children with epilepsy admitted to First Hospital of Zhangjiakou City from January 2017 to January 2020 were selected.They were randomly divided into 8 groups,with 50 cases in each group.They were monitored by video-based EEG for 1,2,4,6,8,10,12 and 24 h.The EEG positive rate and EEG characteristics of epileptic children in different periods were recorded,and the EEG characteristics and positive detection of different seizure types were analyzed.Results:There were significant differences among groups at different monitoring time points(P<0.05).With the increase of monitoring time,the positive rate increased gradually,and the positive rate was 100%at 12 h.There was no significant difference between 6 and 12 h(P>0.05).Of the 360 children with positive detection,64 had generalized tonic clonic seizures,28 clonic seizures,21 tonic seizures,48 absence seizures,29 myoclonic seizures,34 atonic seizures,43 simple partial seizures and 93 complex partial seizures.Patients with different attack types exhibited different clinical manifestations and EEG characteristics.The detection rate of generalized seizures was the highest at 6 hours of monitoring,and the detection rate of localized seizures was the highest at 12 hours of monitoring.Conclusion:Videobased EEG monitoring of children with epilepsy has good practical value.EEG characteristics can be used to judge the attack types of children.The positive rate is 100%after monitoring for 12 h,and the monitoring cost-effectiveness is the highest when monitoring for 6 h,which can basically meet the needs of clinical diagnosis.