中国实用儿科杂志

中国实用儿科杂志 ›› 2011, Vol. 26 ›› Issue (07): 535-.

• 论著 • 上一篇    下一篇

额叶癫痫27例视频脑电图特征分析

  

  1. 中国医科大学附属盛京医院，沈阳　110004
  • 出版日期:2011-07-06 发布日期:2011-07-06

THE video-EEG characteristics of 27 children with frontal lobe epilepsy.

  1. Department of Pediatric Neurology，Shengjing Hospital of China Medical University，Shenyang 10004，China
  • Online:2011-07-06 Published:2011-07-06

摘要：

探讨额叶癫痫临床症状和视频脑电图（VEEG）特征及其与睡眠的相关性。方法　2010年10月至2011年1月中国医科大学附属盛京医院小儿神经内科确诊的27例额叶癫痫患儿，对VEEG监测期间的55次发作进行分析，发作特点及脑电图特征分别由有经验的临床医师和脑电图医师进行双盲分析。结果　22例中6例（22.2%）仅于清醒时发作，11例（50.0%）仅于睡眠时发作，清醒、睡眠无有发作5例（27.8%）55次癫痫发作表现复杂，运动症状突出，主要形式表现为过度运动性自动症23次（41.8%），伴不同程度意识障碍及发声16次（29.1%），姿势性强直发作15次（27.3%），口咽自动症14次（25.5%），先兆10次（18.2%），局部阵挛发作8次（14.5%），偏转性强直6次（10.9%），临床下放电5次（9.1%），发作后朦胧4次（7.3%），额叶失神3次（5.5%）。发作间期脑电图能定位于额叶者19例（70.4%）。51次监测到临床发作，脑电图表现为发作时或发作前瞬间脑电图改变为额区起源的局灶性痫样波发放。结论　额叶癫痫是一组临床表现复杂多样的癫痫综合征，发作间期及发作前瞬间脑电图改变具有重要的定位诊断意义，睡眠时VEEG尤为重要。

关键词: 额叶癫痫, 视频脑电图, 癫痫发作表现

Abstract:

To explore clinical features，ictal and interictal EEG characteristics of frontal lobe epilepsy. Methods　A total of 27 patients，who were diagnosed with frontal lobe epilepsy in the Department of Pediatrics of Shengjing Hospital of China Medical University，were studied with the long-term video-EEG（VEEG）monitoring. The performance of 55 times clinical data and EEG findings were double-blind  analyzed by seasoned doctor and technician. Results　In this 27 patients，6 cases（22.2%）  only attacked when awake，11 cases（50.0%）only attacked when sleep，the other 5 cases（27.8%） were no Specificity. The performance in 55 times of seizures was complex，motor symptoms prominent；the main form was somato-automatism（in 23 times，41.8%），followed by postural-tonic seizures（in 15 times，27.3%），often accompanied by varying degrees of disturbance of consciousness and voice（in 16 times，29.1%）；Oral automatisms（in 14 times，25.5%），aura（in 10 times，18.2%） and partial-clonic seizures（in 8 times，14.5%），version seizures（in 6 times，10.9%），subclinical  discharges（in 5 times，9.1%），postictal mental confusion（in 4 times，7.3%），and absence seizures（in 3 times，5.5%），also have emerged. Interictal EEG could be located in the frontal lobe in 19 patients （70.4%）；in 51 times（92.8%）clinical seizures were captured by video，the abnormal rhythm in frontal region appeared in clinical attacks or before clinical attacks. Conclusion　Frontal lobe epilepsy is a syndrome with extremely complex and diverse epileptic clinical manifestations.The transient changes in EEG before clinical onset are of more important localizing value for frontal lobe epilepsy.

Key words: frontal lobe epilepsy, video-EEG, clinical epileptic manifestations