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热性惊厥患儿的脑电图异常波形及形成特点分析(附280例报告)
http://www.100md.com 2011年9月1日 《医学新知·综合版》 20119
     (湖南郴州市第一人民医院儿童医院 湖南 郴州 423000) 

    【摘要】 目的;探讨热性惊厥患儿波形和部位分布的特点。方法通过对280例临床诊断为热性惊厥的患儿采用视频睡眠剥夺脑电图2h进行回顾性分析, 观察其波形和部位分布的特点。结果206例单纯性热惊厥患儿异常VEEG178例(86.4% ),正常28例(13.6% ),出现不典型尖波散发或成簇发放92例 (44.7% ),有尖(棘)慢波 棘波痫样放电伴有或不伴有背景活动减慢51例 (24.8% ),12例(5.8%)仅有背景活动变慢;其他如纺锤波缺如、局灶性异常,阵发性节律性快波异常等23例(11.7%);72例复杂性热性热惊厥患儿中, 34例(47.2% ) 出现痫样放电,伴有或不伴有背景活动减慢;出现不典型尖波16例(22.2%),仅有背景活动减慢7例(9.7%),其他8例(11.1%),7例为正常脑电图,占9.7%。其痫样放电或出现不典型尖波的部位常见于额区和(旁)中央区,其次是中央颞区,再次是顶区和枕区。结论热性惊厥患儿脑波异常以不典型或不规则尖波方式出现最多,常常为额区及(旁)中央区,与患儿的发育不成熟、脑功能不稳定关系密切,以及与额区具有较多功能和解剖区域,存在不同的放电传播途径有关。
, 百拇医药
    【关键词】 热性惊厥; 脑电描记术;儿童;痫样放电

    【中图分类号】 R742.1

    【文献标识码】 A【文章编号】1044-5511(2011)09-0152-02

    【Abstract】 Objective Explore thermal wave and parts of children of the convulsions of the distribution of the characteristics. Methods Through to the 280 cases of clinical diagnosis for thermal seizures by video children sleep deprivation eeg 2 h were analyzed retrospectively, observe the waveform and areas of the characteristics of distribution. Results 206 cases of overweight children VEEG178 hot convulsions abnormal cases (86.4%), and normal 28 patients (13.6%), appear typical pointed out or wave clusters sent 92 cases (44.7%), has a point (the) slow wave wave was associated with or without sample discharge background activity to slow down the 51 patients (24.8%), 12 patients (5.8%) only background activity slow; Other such as spindles absent, focal abnormalities, paroxysmal rhythmic fast wave abnormal 23 cases (11.7%); 72 cases of complexity thermal heat convulsions, 34 cases in children (47.2%) revealed epileptiform discharge, with or without background activity slackened; Appear not typical pointed wave in 16 (22.2%), only background activity to slow down the 7 cases (9.7%), other 8 cases (11.1%), 7 cases of normal eeg, accounted for 9.7%. The sample discharge or not have seizures pointed to the parts of the typical wave in frontal area and, secondly, the central () is the central temporal region, once again, is the top area and pillow area. Conclusion 
, 百拇医药
    Hot sex children with brain waves convulsions abnormal typical or irregular wave style appears the most pointed, often for the forehead area and the central area, and () children's growth is not mature, brain function is not stable, and closely with frontal area has the multi-function and anatomical area, there are different discharge the transmission way. 

    【Keywords】 thermal convulsions; Brain electrical operation was; Children; Sample discharge seizures 
, http://www.100md.com
    国内外研究表明:热性惊厥患儿脑电图的异常与患儿的年龄、高热的温度、发作的次数密切相关 。但其波形和部位分布的特点,目前研究尚不多。我科经2010年10月至2011年5月对收治并进行视频脑电图2h检查的280例(其中206例单纯性及74例复杂性热惊厥患儿)热性惊厥的患儿,对其记录和回放的脑电图进行了波形和分布特点的观察和临床分析,现报告如下。

    1.资料与方法

    1.1.资料本组患儿280例,年龄为6个月~3岁, 平均年龄为1.21±0.37 岁,男124例,女156例;结合临床诊断单纯性热惊厥206例,复杂性热惊厥74例。发热多数因上呼吸道感染引起,,临床诊断同单纯性热性惊厥及复查性热性惊厥国际标准 [1]。体温多数38℃~40. 5℃,抽搐1次~数次,惊厥时表现:四肢强直抽搐,双眼上翻,伴有或不伴有口吐白沫,或者部分呈单侧肢体抽动,头偏一侧,持续5~30min不等,所有病例进行详细的体格检查及神经系统检查。排除脑外伤及中枢神经系统感染;严重的代谢异常如低钙血症等;既往有过癫痫发作史者。

    1.2.方法患儿于惊厥发作24h内进行,采用日本光电视频脑电图仪描记,按国际10/20系统放置头皮电极,取A1、A2为参考电极。检查前根据年龄不同进行3-6h不等时间的剥夺睡眠,不合作者除外,检查时间为2h。患儿的发作形式除通过VEEG记录外,还由临床两位医生/技师加以观察。, 百拇医药(李沁晏 蒋鸿飞 宋战义)
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