急性中、重型脑外伤后早期癫痫的脑电图监测及预后评价

Clinical study and electroencephalogram(EEG) monitoring of early post-traumatic seizures on acute moderate and severe head injuries

目的:探讨急性中重型脑伤后早期癫痫发生的高危因素;诊断昏迷状态中非惊厥性癫痫或非惊厥性癫痫持续状态(NCS或NCSE)。方法:选用视频脑电监测系统,对86例急性中重型脑伤患者进行1周的EEG监测。结果:(1)86例脑伤患者中7例(8.14％)有癫痫的临床发作,6例(6.98％)为NCS或NCSE。(2)脑伤越重特别是有颅内出血者,早期癫痫发生的可能性越大,尤其是NCSE,差异有显著性意义;性别、年龄差异无显著性意义。结论:重型、特重型脑伤及颅内出血者是早期癫痫发生的高危因素,特别是NCSE;脑伤后昏迷状态即使没有癫痫的临床发作也应常规进行EEG监测,以便临床及时处理。

AIM: To reveal specific risk factors of early post - traumatic seizures on a-cute moderate and severe head injuries and the presence of nonconvulsive seizured(NCS) or nonconvulsive status epilepticus (NCSE). METHODS:86 patients with acute moderate and severe head injuries were monitored with video-EEC for one week. RESULTS: (1) 7 of 86(8. 14% ) patients with acute moderate and severe head injury appeared clinical seizures and 6 cases (6.98% ) showed NCSE. (2) Early post-traumatic seizures, specially NCSE occurred more easily in patients with severer head injuries and intracranial haemorrhage. It were not significantly different in sex and age. CONCLUSIONS: Severer head injuries and intracranial haemorrhage were found to be specific risk factors to early post-traumatic seizures, specially to NCSE. EEG should be included in the routine evaluation of traumatic coma even if clinical seizure activity is not apparent