Creutzfeldt-Jakob病患者的脑电图特点

The correlation between the electroencephalogram findings and clinical manifestations of Creutzfeldt-Jakob disease

目的 探讨Creutzfeldt Jakob病 (CJD)脑电图与临床的关系。方法 对 13例CJD病人在病程的不同阶段进行动态的脑电图 (脑电图 )观察。并将脑电图改变与临床症状和体征进行分析总结。结果 13例病人中 ,12例均出现典型的周期性尖慢复合波 (PSWC)。其中 8例出现于临床发生肌阵挛及无动性缄默后 ,2例出现于肌阵挛发生后无动性缄默前 ,其余 2例分别出现于肌阵挛前无动性缄默发生时和肌阵挛后无动性缄默发生时。疾病不同阶段有不同的特征性脑电图。在PSWC出现前脑电图改变中 ,额部间歇性节律性三相波或delta波可能是PSWC出现的先兆。结论 PSWC与肌阵挛及无动性缄默密切相关 ,临床出现无动性缄默和 /或肌阵挛是检测PSWC的最佳时机。

Objective To investigate the correlation between the EEG findings and the clinical signs of Creutzfeldt Jakob disease (CJD). Methods Serial standard recording during different stage of disease was conducted among 13 patients with CJD, 10 males and 3 females, with the year of onset of 58.2 (49～65). The EEG findings were analyzed in combination of the clinical symptoms and signs. Results 12 of the 13 patients showed typical periodic sharp wave complexes (PSWCs), occurring after the onset of myoclonus and akinetic mutism in 8 patients, both after myoconus and before akinetic mutism in 2 cases, and just at the onset of akinetic mutism before or after the onset of myoclonus respectively in 2 cases. Different EEG features were observed in different stages of disease. Frontal intermittent rhythmic delta activity (FIRDA) and frontal intermittent rhythmic triphasic slow wave, which was replaced by PSWC later, were seen in 4 cases. Conclusion PSWC has a close association with myoclonus and akinetic mutism. The best time of EEG recording is when myoclonus and/or akinetic mutism happen. FIRDA and frontal intermittent rhythmic triphasic slow wave may be hint of the onset of PSWC.