脑电图高峰节律紊乱的临床意义及其变异型

Hypsarrhythmia and its Variants

摘要:

目的 探讨脑电图高峰节律紊乱 (Hypsarrhthmia)的临床意义及其变异类型。 方法 结合临床分析 181例有高峰节律紊乱病人的脑电图。结果 181例表现高峰节律紊乱的患者中婴儿痉挛 (West综合征 ) 10 9例(6 0 % ) ,非West综合征癫痫 6 0例 (33% ) ,没有惊厥病史者 11例 (6 % ) ,包括精神运动发育迟缓 7例 (4 % ) ,Rett综合征 3例 (2 % )。非West综合征癫痫 6 0例患者中 ,继发性癫痫为主 ,有明显脑器质性损害者 37例 (6 2 % ) ,伴有精神运动发育落后者 2 1例 (35 % )。高峰节律紊乱变异类型最常见者为爆发抑制 ,占 10 0例 (5 5 % ) ,而典型高峰节律紊乱只见于 74例 (4 1% ) ,其它较常见的变异类型为周期性 5 4例 (30 % ) ,不对称型 2 5例 (14% ) ,同步化 2 2例(12 % )。随睡眠加深 ,由典型高峰节律紊乱变为爆发抑制者 43例 (2 4% )。结论 认识HYPS的临床意义及其变异类型有利于提高有关疾病的脑电图及临床诊断水平。

Abstract:

Objective To explore the clinical significance of electroencephalographic (EEG) hypsarrhythmia and its variants. Methods We reviewed case histories of 181 patients whose EEG manifested hypsarrhy thmia. Results Of the 181 patients, there were 109 cases of the West syndrome (60%), 60 cases of non West syndrome epilepsy (33%), and 11 cases with no convulsive history (6%). Among the 60 cases with non West syndrome epilepsy, 37 cases were complicated by cerebral organic insults and 21 by psychomotor retardation. The most common hypsarrhythmic variant was burst suppression (n=100, 55%), wherease typical hypsarrhythmia existed in only 74 cases (41%). Other common variants were periodic hypsarrhythmia, interhemispheric asymmetry, and increased interhemispheric synchrony. As sleep advanced, 43 cases with typical hypsarrhythmia changed into a burst suppression pattern. Conclusions Understanding hypsarrhythmia and its variants is important in the diagnostic evaluation of EEGs.