蝶骨电极脑电图在精神运动性癫痫中诊断价值及影响因素分析

Diagnostic value of sphenoid electrode electroencephalogram in psychomotor epilepsy and its influencing factors

目的 研究蝶骨电极脑电图在精神运动性癫痫中的诊断价值及影响因素。方法 选取2018年1月-2020年10月秦皇岛军工医院神经内科收治的93例精神运动性癫痫患者为研究对象,患者均接受常规脑电图检查和蝶骨电极脑电图检查。分析比较蝶骨电极脑电图及常规脑电图对不同发作类型的精神运动性癫痫诊断效能,蝶骨电极脑电图诊断阳性及阴性的精神运动性癫痫患者基线情况。统计分析蝶骨电极脑电图诊断阳性的影响因素及精神运动性癫痫患者蝶骨电极脑电图表现。结果 与常规脑电图检查准确率(27.27%、23.81%、18.75%)比较,蝶骨电极脑电图对强直阵挛发作型(57.58%)、单纯部分性发作型(66.67%)、复杂部分性发作型(81.25%)精神运动性癫痫诊断准确率及整体诊断准确率增高,差异有统计学意义(P<0.05)。与蝶骨电极脑电图诊断阴性的精神运动性癫痫患者比较,蝶骨电极脑电图诊断阳性的精神运动性癫痫患者缺氧窒息史率、无发作诱因率增高,发作持续时间较长,差异有统计学意义(P<0.05),两组发病年龄、性别、体质量指数(BMI)、癫痫家族史、检查时睡着情况、癫痫发作类型、病程组间比较,差异无统计学意义(P>0.05)。Logistic线性回归分析证实,有缺氧窒息史(OR=6.098、95%CI=1.697~4.721)、发作持续时间(OR=2.662、95%CI=1.491~4.469)、无发作诱因(OR=4.216、95%CI=2.481~7.135)均是蝶骨电极脑电图诊断阳性的独立影响因素(P<0.05)。61例经蝶骨电极脑电图检出的患者,其中21例左侧中区为主棘波、棘慢波发放,20例左侧中线区为主棘波发放;12例双侧中颞区为主棘波、棘慢波发放,4例左侧中线区为主棘波发放,4例为右侧中线区主棘波发放。结论 蝶骨电极脑电图在不同发作类型的精神运动性癫痫中具有较高诊断效能,而有缺氧窒息史、发作持续时间、无发作诱因均是蝶骨电极脑电图诊断阳性的独立影响因素。

Objective To investigate the diagnostic value and the influencing factors of sphenoid electrode electroencephalogram in psychomotor epilepsy.Methods 93 patients with psychomotor epilepsy in the hospital from January2018 to October 2020 were selected as the research object.All patients underwent routine EEG and sphenoid electrode EEG.The diagnostic efficacy of sphenoid electrode EEG and conventional EEG in different seizure types of psychomotor epilepsy were analyzed and compared.The baseline situation of the patients of psychomotor epilepsy with positive and negative sphenoid electrode EEG diagnosis were analyzed and compared.The influencing factors of positive diagnosis of sphenoid electrode EEG and manifestations of sphenoid electrode EEG in patients with psychomotor epilepsy were statistically analyzed.Results Compared with the accuracy of routine EEG(27.27%,23.81%,18.75%),the accuracy of sphenoid electrode EEG in diagnosis and overall diagnosis of psychomotor epilepsy in tonic clonic seizure type(57.58%),simple partial seizure type(66.67%),complex partial seizure type(81.25%) were significantly higher(P < 0.05).Compared with the patients of psychomotor epilepsy with negative sphenoid electrode EEG diagnosis,the patients of psychomotor epilepsy with positive sphenoid electrode EEG diagnosis had higher history rate of hypoxia asphyxia and no seizure inducement rate,and longer seizure duration(P < 0.05).There was no significant difference between the two groups in age of onset,gender,body mass index(BMI),family history of epilepsy,sleeping during examination,type of seizure and course of disease(P > 0.05).Logistic linear regression analysis confirmed the history of hypoxic asphyxia(or = 6.098,95% CI = 1.697 ~ 4.721),duration of attack(or = 2.662,95% CI = 1.491 ~ 4.469)and no inducement of attack(or = 4.216,95% CI = 2.481 ~ 7.135) were independent influencing factors of positive diagnosis of sphenoid electrode EEG(P < 0.05).61 patients were detected by sphenoid electrode EEG,of which 21 cases were main spike wave and slow spike wave in the left middle area,and 20 cases were main spike wave in the left midline area;in 12 cases,the bilateral middle temporal region was main spike wave and spike slow wave;in 4 cases,the left midline region was main spike wave;in 4 cases,the right midline region was main spike wave.Conclusion Sphenoid electrode EEG has high diagnostic efficacy in different seizure types of psychomotor epilepsy.The history of hypoxia asphyxia,seizure duration and no seizure inducement are independent influencing factors of positive diagnosis of sphenoid electrode EEG.