视频脑电图的时频图在快速鉴别诊断发作性疾病中的价值

The value of time-frequency gram based on video electroencephalography in rapiddifferential diagnosis of paroxysmal diseases

目的 探讨视频脑电图(VEEG)结合时频图(DSA)在快速鉴别诊断发作性疾病的价值。方法 采用回顾性分析,选取发作性疾病患者122例,收集临床资料,所有患者进行常规脑电图(EEG)及长时程视频脑电图监测,进行原始脑电图及时频图分析。结果 122例患者常规EEG出现癫痫样放电发生为33例(27.05%),长时程VEEG癫痫样放电59例(48.36%),长时程VEEG癫痫样放电率明显高于常规EEG(P<0.05)。长时程VEEG 67.80%癫痫样放电见于醒睡各期,32.20%仅出现在睡眠期。全面性放电40.68%,局灶性放电59.32%。监测到痫性发作共18例,全面性8例,局灶性10例。24例全面性放电及18例临床痫性发作的时频图表现为慢波功率增高。结论 长时程的视频脑电图使癫痫样放电的检出率明显提高,结合时频图可快速发现阵发性放电及临床痫性发作,有效节省阅图时间。

Objective To explore the value of video electroencephalography(VEEG)combined with time-frequency gram(DSA)in rapid differential diagnosis of paroxysmal diseases.Methods A retrospective analysis was used to select 122 patients with paroxysmal diseases.The clinical data were collected.Routine electroencephalography and long-term video electroencephalography were performed on all patients and original electroencephalography and time frequency analysis were performed.Results The incidence of epileptiform discharges in 122 patients with conventional electroencephalography was 33(27.05%),and the incidence of epileptiform discharges in long-term VEEG was 59(48.36%).The incidence of epileptiform discharges in long-term VEEG was significantly higher than that in conventional electroencephalography(P<0.05).67.80%of long range VEEG epileptic discharges were observed in various stages of sleep,while 32.20%only appeared in the sleep phase.Comprehensive discharge was 40.68%,and focal discharge was 59.32%.A total of 18 cases of epileptic seizures were detected,including 8 cases of comprehensive seizures and 10 cases of focal seizures.The time-frequency maps of 24 cases of comprehensive discharge and 18 cases of clinical epileptic seizures showed an increase in slow wave power and abnormal increase in wave amplitude in the red area,forming a significant peak compared to the absence of epileptiform discharge and seizures.Each reading time of original electroencephalography combined with time-frequency chart was significantly shorter than that of simple original electroencephalography.Conclusion Long term video electroencephalography can significantly improve the detection rate of epileptic discharges.Paroxysmal discharges and clinical epileptic seizures can be quickly found by combining with time-frequency gram,and it can effectively saving the time of reading.