自身免疫性脑炎患儿脑电图特征与行为神经发育研究

EEG characteristics and behavioral neurodevelopment in children with autoimmune encephalitis

目的探讨自身免疫性脑炎(AE)患儿的脑电图特征与行为神经发育。方法收集2020年5月至2023年4月在惠州市中心人民医院住院诊治的AE患儿67例作为脑炎组,同期选择67例儿童志愿者作为对照组。所有小儿接受脑电图监测,记录脑电图表现,同时评估行为神经发育评分。结果在67例脑炎患儿中,临床表现为意识障碍28例,语言障碍33例,记忆障碍24例,抽搐18例,精神行为异常23例,走路姿势异常9例。脑炎组患儿脑电图表现为背景变慢23例,癫痫样放电17例,爆发-抑制8例,平坦10例,低电压9例;对照组表现为背景变慢2例,阵发性慢波增多2例。两组脑电图异常情况比较,差异具有统计学意义(P<0.05)。脑炎组的行为神经发育评分(28.32±0.43)低于对照组(38.22±0.35),差异具有统计学意义(t=146.157,P<0.001)。结论自身免疫性脑炎患儿临床表现多样,脑电图监测多表现为背景变慢、癫痫样放电、爆发-抑制等,且伴有行为神经发育异常。

Objective To explore the EEG characteristics and behavioral neurodevelopment in children with autoimmune encephalitis(AE).Methods A total of 67 children with AE hospitalized in Huizhou Central People's Hospital from May 2020 to April 2023 were enrolled as the AE group,and 67 children volunteers were selected as the control group during the same period.All children underwent EEG monitoring.EEG manifestations and behavioral neurodevelopmental scores were recorded.Results Among the 67 children with AE,there were 28 cases of consciousness disturbance,33 cases of language disturbance,24 cases of memory disturbance,18 cases of convulsions,23 cases of mental behavior abnormalities,and 9 cases of abnormal walking posture.In the AE group,the EEG showed slow background in 23 cases,epileptoid discharge in 17 cases,burst suppression in 8 cases,flat in 10 cases,and low voltage in 9 cases.In the control group,there were 2 cases with slower EEG background and 2 cases with increased paroxysmal slow waves.There was a significant difference in the abnormal EEG between the two groups(P<0.05).The behavioral neurodevelopmental score in the AE group(28.32±0.43)was lower than that in the control group(38.22±0.35),and the difference was statistically significant(t=146.157,P<0.001).Conclusion The clinical manifestations of children with AE are varied,and EEG monitoring mostly shows background slowing,epileptiform discharge,burst inhibition,etc.,accompanied by behavioral neurodevelopmental abnormalities.