动态脑电图对癫痫患儿停用抗癫痫药物后复发的评估价值

Value of Dynamic Electroencephalography in the Evaluation of Recurrence of Epileptic Children After Withdrawal of Antiepileptic Drugs

目的探讨动态脑电图对癫痫患儿停用抗癫痫药物后复发的评估价值。方法回顾性分析郑州大学附属郑州中心医院2019年1月至2021年5月收治的112例癫痫患儿的临床资料,根据患儿停用抗癫痫药物后1 a内复发情况将其分为复发组(29例)和未复发组(83例)。分析患儿停药前动态脑电图资料,比较两组患儿棘尖波数量、慢波数量、慢波出现方式。结果在棘尖波数量方面,复发组患儿中量棘尖波型占比最多,其次为少量棘尖波型、大量棘尖波型、无棘尖波型;未复发组患儿少量棘尖波型占比最多,其次为无棘尖波型、中量棘尖波型、大量棘尖波型;两组患儿棘尖波数量比较,差异有统计学意义(P<0.05)。在慢波数量方面,复发组患儿中量型占比最多,其次为少-中量型、少量型、中-大量型、大量型;未复发组患儿以少量型占比最多,其次为少-中量型、中量型、中-大量型、大量型;两组患儿慢波数量比较,差异有统计学意义(P<0.05)。在慢波出现方式方面,复发组患儿以阵发性(P型)慢波为主,其次为散在性(S型)、局灶性(F型);未复发组患儿以S型为主,其次为P型、F型;两组患儿慢波出现方式比较,差异有统计学意义(P<0.05)。结论癫痫患儿停用抗癫痫药物前动态脑电图显示中量、大量棘尖波,中量、中-大量、大量慢波,P型慢波时,考虑延缓停药,以降低癫痫患儿复发风险。

Objective To explore the value of dynamic electroencephalography in evaluating the recurrence of epileptic children after withdrawal of antiepileptic drugs.Methods A retrospective analysis was conducted on the clinical data of 112 children with epilepsy admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 2019 to May 2021.They were divided into a recurrent group(29 cases)and a non recurrent group(83 cases)based on the recurrence rate within one year after discontinuing antiepileptic drugs.The dynamic electroencephalography data of children before drug withdrawal were analyzed,and the number of spike and spike waves,the number of slow waves,and the appearance of slow waves were compared between the two groups.Results In terms of the number of spike waves,the recurrent group had the highest proportion of spike wave types,followed by a small number of spike wave types,a large number of spike wave types,and no spike wave types.The non recurrent group had the highest proportion of small amount of spike wave type,followed by non spike wave type,medium amount spike wave type,and large amount spike wave type.There was a statistical significant difference in the number of spike waves between the two groups of children(P<0.05).In terms of the number of slow waves,the recurrent group had the highest proportion of moderate type,followed by low to moderate type,small amount type,medium to large amount type,and large amount type.The proportion of children in the non recurrent group was the highest in small amounts,followed by small to medium,medium,medium to large,and large amounts.There was difference in the number of slow waves between the two groups of children(P<0.05).In terms of the mode of slow wave occurrence,the recurrent group of children mainly had paroxysmal(P-type)slow waves,followed by scattered(S-type)and focal(F-type).The non recurrent group was mainly characterized by S-type,followed by P-type and F-type.There was a statistical significant difference in the occurrence of slow waves between the two groups of children(P<0.05).Conclusion The dynamic electroencephalography of epileptic children before withdrawal of antiepileptic drugs shows moderate and large spike waves,moderate,medium large and large slow waves,and P-type slow waves.When the withdrawal of antiepileptic drugs is delayed,the risk of recurrence of epileptic children should be reduced.