表面肌电图、视频脑电图联合心电图诊断小儿癫痫运动性发作的价值

Value of combining surface electromyography with video EEG and ECG in the diagnosis of motor seizures in children with epilepsy

目的研究表面肌电图、视频脑电图联合心电图诊断小儿癫痫运动性发作的价值。方法在我院神经内科2019年4月至2020年10月收诊的疑似小儿癫痫患儿142例为研究对象,均表现为反复的运动性发作,对全部患儿进行表面肌电图、视频脑电图和心电图检查,统计诊断结果。结果本组142例患儿经检查有82例为癫痫样发作,被确诊为癫痫,其中单纯视频脑电图诊断小儿癫痫的准确率为91.46%(75/82),低于视频脑电图与表面肌电图、心电图联合检测诊断准确率100.0%(82/82),差异有统计学意义(P<0.05)。不同的运动性发作类型,视频脑电图的发作期、发作间期有典型特征,且同步心电图可监测到癫痫发作时心率加快;四种不同运动性发作类型的表面肌电图时程和心电图时程均在10 s内,且差异均无统计学意义(P>0.05),运动性发作与肌电图、心电图同步。结论表面肌电图、视频脑电图和心电图的联合应用监测有助于早期检出小儿癫痫,并准确区分癫痫的运动性发作类型,指导临床治疗。

Objective To study the value of combining surface EMG with video EEG and electrocardiogram in the diagnosis of motor seizures in children with epilepsy.Methods Totally 142 children suspected with epilepsy were treated in the Department of Neurology of our hospital from April 2019 to October 2020,all of whom showed recurrent motor seizures,and they were included as research subjects.All the children were examined by surface electromyography,video EEG and electrocardiogram,and the diagnostic results were counted.Results Among the 142 children who were examined,82 were diagnosed with epilepsy;the diagnosis accuracy of pure video EEG was 91.46%(75/82),which was lower than that of the combined diagnosis(100.0%,82/82),there being a statistically significant difference(P<0.05).For different types of motor seizures,the onset period and seizure interval of video EEG had typical characteristics,and the synchronous ECG showed the accelerated heart rate at seizures;the surface EMG duration and ECG duration of four different seizure types were within 10 s,and the difference was not statistically significant(P>0.05);motor seizure was synchronized with EMG and ECG.Conclusion The combined monitoring of surface EMG,video EEG and ECG is helpful to detect early epilepsy in children,accurately distinguish the types of motor seizures,and guide clinical treatment.