癫癎夜间发作患儿癎样放电及睡眠结构特征分析

Epileptiform discharges and sleep structure in children with nocturnal epilepsy

摘要:

目的：研究癫癎夜间发作患儿的癎样放电及其睡眠结构特征。方法：选取2009年12月至2011年6月接受夜间12 h视频录像脑电图及整夜多导生理参数睡眠监测仪监测的癫癎夜间发作患儿54例为病例组，对其脑电图癎样放电及睡眠结构进行研究。选取同期年龄、性别与病例组相匹配的正常儿童40例为对照组。结果：（1）病例组患儿均出现癎样放电及次数不等的临床发作，其癎样放电与临床发作均以非快速眼动睡眠期的S1、S2期最多。（2）与对照组比较，病例组睡眠结构中S1期和S2期所占百分比明显增高，而(S3+S4)期和快速眼动睡眠期所占百分比明显降低，差异有统计学意义（P<0.01）。结论：夜间发作性癫癎患儿在非快速眼动睡眠期更易出现癎样放电及临床发作，且伴有明显睡眠结构紊乱。

Abstract:

OBJECTIVE: To study the epileptiform discharges and sleep structure in children with nocturnal epilepsy. METHODS: A total of 54 children with nocturnal epilepsy (NE group) between December 2009 and June 2011 were enrolled in this study using a cluster sampling method. Their epileptiform discharges and sleep structure were monitored using nocturnal 12 h-video-echoencephalography (EEG) and polysomnography. Meanwhile, 40 age- and gender-matched normal children were enrolled as the control group. RESULTS: All the 54 children in the NE group suffered from epileptiform discharges and a varied number of clinical seizures, especially at S1 and S2 states. Compared with the control group, S1 and S2 states had significantly higher proportions in the NE group, and S3 and S4 states and REM state had significantly lower proportions (P<0.01). CONCLUSIONS: Epileptiform discharges and clinical seizures are more common in children with nocturnal epilepsy, especially during the non-rapid eye movement sleep. Meanwhile, remarkably disordered sleep structure also exists.