小儿癫痫临床诊断中动态脑电图的应用(1)
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[摘要] 目的 探讨动态脑电图(ambulatory Electroencephalogram，AEEG)在小儿癫痫诊断及鉴别诊断中的应用价值。方法 对2009年1月～2011年4月在我院就诊的156例癫痫患儿和96例非癫痫发作性疾病患儿进行常规脑电图(REEG)和AEEG进行对比研究。结果 AEEG出现痫样放电几率明显高于REEG(AEEG为65.4%，REEG为16.7%)；癫痫组与非癫痫发作性疾病组AEEG的总异常率及痫样放电率差异有统计学意义(P<0.01)；在癫痫组，AEEG证明有痫样放电102例患儿中，清醒期出现痫样放电47例(46.1%)，睡眠期共出现91例(89.2%)，二者比较差异有统计学意义(P<0.01)，睡眠期痫样放电多于清醒期。结论 与REEG相比，AEEG在小儿癫痫的诊断和鉴别诊断中具有更重要的作用。
[关键词] 小儿癫痫；动态脑电图
[中图分类号] R742.1 [文献标识码] B [文章编号] 1673-9701(2011)26-154-02
Application Value of AEEG on the Diagnosis in Children Epilepsy
MAO Ying WANG Fang
Shaoxing People’s Hospital， Zhejiang University Shaoxing Hospital，Shaoxing 312000，China
[Abstract] Objective To explore the application value of AEEG on the diagnosis and differential diagnosis in children epilepsy. Methods The contrast study of routine electroencephalography(REEG) and ambulatory electroencephalography(AEEG) of 156 cases with epilepsy and 96 cases with non-epileptic attack disorder in our hospital from January 2009 to April 2011 was done. Results Epileptiform discharges appear on AEEG were significantly more than on REEG(AEEG 65.4%，REEG 16.7%)；Both the total abnormal rate and epileptiform discharge had remarkable difference between two groups(P<0.01). In 102 cases which were epileptiform discharge detected by AEEG of epilepsy group，of which 47 cases(46.1%) occurred epileptic discharge in awake stages and 91 cases(89.2%) occurred in sleep stages，it had remarkable difference(P<0.01). There were more epileptiform discharges during sleep than awake stages. Conclusion To compared with REEG，AEEG plays a more important role in the diagnosis and differential diagnosis of children epilepsy.
[Key words] Children epilepsy；Ambulatory electroencephalography
癫痫是一系列临床症候的综合表现，是大脑神经元兴奋性过高导致的突发异常过量放电而引起的大脑功能障碍的一种慢性疾病。小儿癫痫是因为小儿神经系统发育不全，大脑皮层受到高热或剧烈的精神刺激，产生过度兴奋所致的常见病，由于其特点呈突发性、爆发性和一时性， 因此在脑电图上也是呈爆发的形式表现出来，常规脑电图常常由于短暂的发作时间而无法捕获，而动态脑电图可以做到瞬间记录这些爆发形式的异常波形的特点。为了探讨动态脑电图(AEEG)在小儿癫痫中的应用价值，包括诊断、鉴别诊断、相关治疗以及预后判断，笔者2009年1月～2011年4月对我院门诊和病房的156例癫痫患儿和96例非癫痫发作性疾病的患儿在住院期间均行常规脑电图(REEG)及AEEG检测， 并结合临床资料进行分析，以探讨AEEG对儿童癫痫的诊断、鉴别诊断、治疗及预后判断价值，现将观察情况报道如下 ......
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