中国实用儿科杂志

中国实用儿科杂志

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脑电图额-枕同步放电现象的电临床研究

  

  1. 北京大学第一医院 儿科，北京  100034
  • 出版日期:2019-04-06 发布日期:2019-07-03

Electrical and clinical study of the synchronous occipital and frontopolar spikes phenomenon

  1. Department of Pediatrics，Peking University First Hospital，Beijing  100034，China
  • Online:2019-04-06 Published:2019-07-03

摘要：

目的　分析癫痫患儿发作间期脑电图（EEG）额-枕同步放电现象的临床特征。方法　对2013年7月至2018年1月在北京大学第一医院儿科行视频脑电图（VEEG）检查且存在额-枕同步放电现象的患儿临床及EEG资料进行回顾性分析。结果　55例存在额-枕同步放电现象，其中男34例、女21例。EEG记录到额-枕同步放电年龄为2岁6个月至14岁，中位年龄6岁6个月。12例为额-枕同侧同步放电，12例为对侧同步放电，17例为双侧同步放电，7例为双侧同步偏同侧同步放电以及7例双侧同步偏对侧同步放电。额-枕同步放电在位相上存在时间差，42例枕区放电较额区提前出现，3例额区放电在枕区放电之前，10例不易分辨前后。结合病因学，33例诊断为Panayiotopoulos 综合征、13例为结构性病因导致癫痫、1例抗N-甲基-D-天冬氨酸（NMDA）受体脑炎后继发癫痫、2例代谢性疾病导致癫痫及6例为病因不明性癫痫。结论　额-枕同步放电现象常在儿童期出现或由早期其他放电形式演变而来。该现象可表现为同侧同步或双侧交叉同步模式，多数为枕区放电较额区提前出现。该放电现象在Panayiotopoulos综合征中最常见，也可见于其他不同病因导致的癫痫。

关键词: 脑电图, 癫痫, 额-枕同步放电

Abstract:

Objective　To study the clinical characteristics of epileptic patients with synchronous occipital and frontopolar spikes phenomenon. Methods　The clinical data，EEG features of patients with synchronous occipital and frontopolar spikes phenomenon were retrospectively reviewed. Results　Totally 34 male and 21 female patients had synchronous occipital and frontopolar spikes. Ages at the time of recording the synchronous occipital and frontopolar spikes phenomenon ranged from 2 years 6 months to 14 years with the median age of 6 years 6 months. In the total 55 patients，12 patients had contralateral synchronous discharges，12 patients had ipsilateral synchronous，17 patients had bilateral synchronous discharges，7 patients had bilateral synchronous discharges tending to contralateral synchronously，and 7 patients had bilateral synchronous discharges tending to ipsilateral synchronously. Occipital preceded frontopolar discharges in 42 patients. Frontopolar preceded occipital discharges in 3 patients. The phase difference between the occipital and frontopolar spikes could not be distinguished in 10 patients. Based on the etiology and diagnoses，there was Panayiotopoulos syndrome in 33 patients，epilepsy with structural abnormality in 13 patients，secondary epilepsy due to immune encephalitis in 1 patient，epilepsy accompanied by inborn error of metabolism in 2 patients and epilepsy with unknown etiology in 6 patients. Conclusion　The synchronous occipital and frontopolar spikes phenomenon usually appears during childhood or develops from other discharge patterns in infancy stage. The synchronous occipital and frontopolar spikes phenomenon can be ipsilateral synchronous or contralateral synchronous discharges. The occipital spikes preceded frontopolar spikes in most patients. The synchronous occipital and frontopolar spikes phenomenon is mostly found in Panayiotopoulos syndrome，but it is also found in epilepsy with different etiologies.

Key words: electroencephalogram, epilepsy, the synchronous occipital and frontopolar spikes phenomenon