摘要
目的:分析低血糖发作的临床和脑电生理特征,探讨低血糖发作与癫痫发作的相关概念及诊治策略。方法:对18例低血糖发作患者的临床症状和发作期及发作间期的脑电图进行分析,至少随访6个月,分析低血糖发作时症状特点和脑电图特征。结果:共纳入低血糖发作患者18例,多数患者于晨起时发作,6例患者发作时意识清楚,12例患者出现意识模糊,缓解后不能完全回忆。全部18例患者均出现行为异常。有15例患者在发作前30 min脑电图出现背景节律明显减慢,前头部导显著;有4例患者发作时脑电图表现为各导阵发性2~3 Hz中-高幅慢波节律;4例患者可见左侧枕、后颞导尖慢、棘慢综合波发放;5例患者发作时,右侧前额、额、前颞导出现阵发性极高幅δ节律。结论:当患者症状表现类似癫痫发作,且同步脑电出现全导弥漫性慢波基础上出现尖慢综合波和阵发性中-极高幅节律及局部尖慢综合波发放,是低血糖发作时的典型脑电图改变,应考虑到低血糖发作的可能。
Objective:To analyze the clinical and electrophysiological characteristics of hypoglycemia,and to explore the diagnosis and treatment of hypoglycemia and epileptic seizures.Methods:The clinical and electroencephalogram(EEG)characteristics of 18 patients with hypoglycemia attack were studied during the attack period and between attacks.The patients were followed up for at least 6 months.Results:Most of the patients had hypoglycemia attack in the morning,6 patients were conscious during the attack,12 patients appeared confusion and could not recall after remission.All the 18 patients had abnormal behavior.In 15 patients,the background rhythm of EEG decreased significantly 30 minutes before the attack,and the lead of forehead were significant.In 4 patients,EEG showed paroxysmal 2-3 Hz middle-high slow wave rhythm in each lead.In 4 patients,the sharp slow and spike slow complex wave was observed in the left occipital and posterior temporal leads.In 5 patients,the paroxysmal high amplitudeδrhythm was observed in the right prefrontal,frontal and anterior temporal leads.Conclusion:The symptoms are similar to epileptic seizure,and the diffuse slow wave with sharp slow complex wave,paroxysmal medium high amplitude rhythm and local sharp slow complex wave appear in the synchronous EEG.It is a typical EEG change during hypoglycemia attack,and the possibility of hypoglycemia attack should be considered.
作者
姜曌
张文娟
刘永红
JIANG Zhao;ZHANG Wenjuan;LIU Yonghong(Department of Neurology,Xijing Hospital,Air Force Military Medial University,Xi’an 710032)
出处
《陕西医学杂志》
CAS
2020年第8期1008-1012,1019,共6页
Shaanxi Medical Journal
关键词
低血糖发作
癫痫
癫痫发作
脑电图
行为异常
长程视频脑电监测
Hypoglycemia attack
Epilepsy
Seizure disorder
Electroencephalogram
Behavior disorder
Long-term video-EEG monitoring
