摘要
目的探讨视频脑电图在癫痫的诊断及定位中的应用价值。方法回顾性分析2011年1月—2014年1月在温州医科大学第一附属医院就诊的有临床发作性症状诊断为癫痫及拟诊为癫痫的78例患者的临床资料,比较常规脑电图(Electroencephalograph,EEG)与视频脑电图((Video-Electroencephalograph,VEEG)在明确癫痫诊断、鉴别诊断中的作用,以及视频脑电图在癫痫致痫灶定位中的价值。结果共纳入研究对象78例,其中癫痫组45例,可疑癫痫组33例。VEEG在癫痫组和可疑癫痫组的痫性放电检出率均高于EEG,差异有统计学意义(P<0.05)。VEEG与EEG总的痫性放电检出率比较,差异有统计学意义(60/18 vs.36/42,χ2=15.60,P<0.001)。VEEG有痫样放电患者同步监测到临床发作者34例(34/60,56.67%),与EEG相比(6/36,16.67)差异有统计学意义(χ2=14.81,P<0.001),VEEG较EEG能够更好地同步记录脑电波异常与临床发作。78名患者同步监测到临床发作与痫样放电者共34名,确诊为癫痫,其中全面强直阵挛性发作9例,失神发作7例,肌阵挛发作7例,单纯部分性发作5例,复杂部分性发作4例,部分性发作继发全身性发作2例。23例根据脑电图确诊起始部位,其中起源于额区7例,颞区6例,枕区5例,额颞区3例,枕颞后区1例,额中央区1例。结论 VEEG在癫痫患者的诊断、分型及定位中明显优于EEG,具有可靠的临床应用价值。
Objective To investigate the role of Video-Electroencephalograph(V-EEG) in the diagnosis and localization of epilepsy. Methods The clinical data of 78 patients with clinical onset was divided into two groups according to clinical symptoms, epilepsy group and suspicious epilepsy group. Every group received both EEG and V-EEG methods. The role of EEG and V-EEG in the diagnosis and localization of epilepsy were analyzed and compared. Results The detection rate of interictal epileptiform discharge and clinical onset by V-EEG in both groups were higher than by EEG( P 〈 0.05 ), and the total detection rate was also higher than EEG(60/18 vs. 36/42, χ2 = 15.60, P 〈 0.1301 ). The detection rate of epileptiform discharges simultaneous monitoring of clinical onset using V-EEG was higher than using EEG(34/60 vs. 6/36, χ2 = 14.81 ,P 〈0.001 ). 34 patients were diagnosed with epilepsy by V-EEG, among those there were 9 cases of generalized tonic-clonie seizures ,7 cases of absence seizures ,7 cases of myoclonic seizures ,5 cases of simple partial seizures ,4 cases of complex partial seizures, and 3 cases of Partial seizures with secondary generalized seizures. According to the various forms of VEEG,the starting position of 23 epilepsy patients were located,including of 7 cases of frontal origin,6 cases of temporal origin,5 eases of occipital origin,3 cases of frontotemporal area, 1 cases of posterior temporal occipital area, 1 cases of the central area. Conclusion In the diagnosis, classification and localization of epileptic patients, V-EEG is significantly better than EEG, V-EEG has a very reliable clinical application.
出处
《中华全科医学》
2015年第10期1619-1621,共3页
Chinese Journal of General Practice
关键词
视频脑电图
癫痫
发作期痫样放电
致病灶
Video-electroencephalograph
Epilepsy
Interictal epileptiform discharge
Epileptogenic focus