52例散发性克雅病患者的脑电图特点分析

Electroencephalographic studies on sporadic Creutzfeldt-Jakob disease

目的分析散发性克雅病(creutzfeldt-jakob disease,CJD)患者的脑电图特点,探索影响三相波出现的因素。方法对2014年1月1日-2019年12月31日期间在北京宣武医院住院的所有确诊及可疑散发性CJD病例的临床资料和脑电图结果进行回顾性分析。结果该研究纳入52例确诊及可疑CJD患者,平均病程为(4.7±5.2)个月。重度异常脑电图占比为34.6%。重度异常脑电图的患者三相波出现率为100%,且其中77.8%为周期性三相波发放。脑电图的基本节律每增加1 Hz,三相波出现将减少58%(OR 0.420,95%CI 0.254~0.690,P=0.001)。中度异常组与重度异常组相比,无锥体外系损伤患者的脑电图更有可能为中度异常,有锥体外系损伤患者的脑电图更严重(B 1.386,OR 4.173,95%CI 1.185~14.701,P=0.026)。有精神异常患者的脑电图中三相波出现比无精神异常者高出4.225倍(OR 5.225,95%CI 1.021~26.728,P=0.047)。结论脑电图异常程度与锥体外系受损有关系。精神异常影响三相波的出现。脑电图严重程度越重,三相波出现率越高。

Objective To investigate the electroencephalogram(EEG)characteristics of 52 patients with sporadic Creutzfeldt-Jakob disease(CJD).Methods The clinical findings and EEG of 52 cases with CJD from the Department of Neurology of Beijing Xuanwu Hospital,Capital Medical University between January 1st,2014 and December 31st 2019 were gathered.The correlation between EEG features and clinical manifestations were studied.Results Fifty-two patients were included in the study(50%men).Severely abnormal EEG were seen in 18/52(34.6%)of patients where triphasic waves were seen in 18/18(100%),classic Periodic Sharp Wave Complex(PSWC)were seen in 14/18(77.8%).Logistic regression revealed that Patients with extrapyramidal symptoms were more likely to have severely abnormal EEG(OR 4.173,95%CI 1.185-14.701,P=0.026)and triphasic waves were detected much more in EEG of patients with psychiatric symptoms(OR 5.225,95%CI 1.021-26.728,P=0.047).Conclusion The presence of PSWC activity has a significant association with severely abnormal EEG.Appearance of extrapyramidal symptoms correlates with severely abnormal EEG.Psychiatric symptoms might be a predictive factor of triphasic waves for sCJD.