头皮脑电图发作间期癫痫样放电对成人癫痫患者认知功能的影响

Effect of Interictal Epileptiform Discharges of Scalp Electroencephalogram on the Cognitive Function of Adult Epileptic Patients

目的探讨头皮脑电图发作间期癫痫样放电(interictal epileptiform discharges,IEDs)对成人癫痫患者认知功能的影响。方法连续选取98例上海德济医院住院的成人癫痫患者,剔除颅内器质性病变、特殊抗癫痫药物和癫痫发作频繁的病例。均采用成人韦氏智力量表和成人韦氏记忆量表测评了解患者的认知功能,并均完成长程视频脑电图监测。以癫痫患者IEDs的不同参数,如放电的部位、放电形式、侧别、时期和放电指数等对癫痫患者进行分组,比较不同组间认知功能是否存在差异。结果成人癫痫患者的认知功能与年龄、起病年龄、病程、抗癫痫药物种类无明显关联,但与IEDs呈负相关。睡眠期放电指数为1%~10%组和10%~50%组相比认知功能差异有统计学意义(P<0.05)。IEDs的放电形式、部位、侧别对癫痫患者认知功能的影响差异无统计学意义(P>0.05)。结论IEDs的放电指数超过10%会对成人癫痫患者的认知功能产生不利影响。

Objective To investigate the effects of interictal epileptiform discharges(IEDs)of scalp electroencephalogram on the cognitive function of adult epileptic patients.Methods A total of 98 adult epileptic patients hospitalized in Shanghai Deji Hospital were selected,and the cases of intracranial organic lesions,special anti-epileptic drugs and frequent epileptic seizures were excluded.The cognitive function of patients was assessed by adult Wechsler Intelligence Scale and adult Wechsler Memory Scale,and long-term video EEG monitoring was completed in all patients.The patients with epilepsy were divided into different parameters of IEDs,including discharge location,discharge form,side,period and discharge index,to compare whether there were differences in cognitive function between different groups.Results The cognitive function of adult epileptic patients had no significant correlation with age,age of onset,course of disease and number of anti-epileptic drugs.However,the cognitive function was negatively correlated with IEDs.There were significant differences in cognitive function between the discharge index of 1%-10% group and 10%-50% group(P<0.05).The discharge form,location and side of IEDs had no difference effect on cognitive function in patients with epilepsy(P>0.05).Conclusion The discharge index of IEDs more than 10%will have adverse effects on cognitive function in adult epileptic patients.