视频脑电图在儿童癫癎诊断及定位中的作用

Role of video electroencephalogram in diagnosis and localization of epilepsy in children

摘要:

目的 比较视频脑电图（VEEG）与常规脑电图（REEG）在儿童癫癎的诊断、癫癎放电起源定位方面的作用。方法 回顾性分析既往有临床发作性症状、可疑癫癎的223 例患儿的临床资料，比较VEEG 与REEG 在监测临床发作、间期癎样放电（IED）、判定IED 起源部位、以及识别非癎样发作方面的作用，比较觉醒期及睡眠期IED 的检出率。结果 VEEG 对IED 的检出率高于REEG（P < 0.01）；VEEG 对癎样放电患儿同步临床发作的检出率高于REEG（P < 0.01）。223 例患儿通过视频脑电图确诊癫癎86 例，78 例确诊为癫癎综合征，31 例诊断为非癫癎样发作，81 例明确癫癎放电起源部位。通过视频脑电图检查，发现IED 在睡眠期检出率（46%）明显高于觉醒期（13.2%）（P < 0.01），并主要集中在 NREM Ⅰ ~ Ⅱ期。结论 VEEG 在儿童癫癎的诊断及定位中的作用明显优于REEG，具有较高的临床应用价值。

Abstract:

Objective To study the role of video electroencephalogram (VEEG) versus regular electroencephalogram (REEG) in the diagnosis of epilepsy and localization of origin of epileptic discharge in children through a comparative analysis. Methods A retrospective analysis was performed for the clinical data of 223 children with clinical paroxysmal symptoms in the past and suspected epilepsy. VEEG and REEG were compared from the aspects of monitoring of clinical seizures, interictal epileptiform discharge (IED), localization of the origin of IED, and identification of non-epileptic seizures, and the detection rate of IED during awakening and sleep stages was also compared. Results Compared with REEG, VEEG had significantly higher detection rates of IED and synchronous clinical seizures in children with epileptiform discharge (P < 0.01). Of all children, 86 were diagnosed with epilepsy, 78 were diagnosed with epilepsy syndrome, 31 were diagnosed with non-epileptic seizures, and 81 had a definite location of the origin of epileptic discharge according to the VEEG. The detection rate of IED in the sleep stage was higher than that in the awakening stage (46% vs 13.2%; P < 0.01), and IED was mainly detected in the NREM I-II stages according to the VEEG. Conclusions VEEG has a significantly better performance than REEG in the diagnosis and localization of epilepsy in children and has a high value in clinical practice.