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目的研究录像脑电图(VEEG)在癫的诊断、鉴别诊断和临床发作分型中的价值,探讨癫患者自然睡眠时相与样放电之间的关系。方法使用录像脑电图对93例发作性疾病患者进行长程脑电监测,记录清醒和睡眠时的脑电图,并作诱发试验,明确发作性质,确定癫的临床发作类型,并分析发作间期癫样放电的睡眠-觉醒时相分布。结果93例发作性疾病患者中有临床发作者51例,样放电者72例,结合病史、临床表现和EEG结果而诊断为癫71例,其中69例患者确定了临床发作类型,20例修正了临床发作类型;71例确诊为癫患者中有完整睡眠-觉醒周期者65例,觉醒期有样放电者49例,睡眠期有样放电者61例,其中NREMⅠ-Ⅱ期52例(85.2%),NREMⅠ-Ⅳ期3例(4.9%),NREWⅢ-Ⅳ期6例(9.9%),REM期未见。结论VEEG检测有利于癫的诊断和确定临床发作分型,睡眠监测有助于样波的检出,睡眠期样放电主要出现于NREMⅠ-Ⅱ期。
Objective To study the value of video-electroencephalogram (VEEG) in the diagnosis, differential diagnosis and clinical type of epilepsy, and to explore the relationship between spontaneous sleep phase and discharge in epileptic patients. Methods Ninety-three patients with paroxysmal disease were monitored by long-range EEG with video-electroencephalography (EEG). EEG was recorded during wakefulness and sleep. Evoked tests were performed to determine the type of seizure onset. The type of clinical seizure was determined. Phase epileptiform discharge sleep - awakening phase distribution. Results Of the 93 patients with seizures, 51 were clinically diagnosed and 72 were discharged. The 71 patients with epilepsy were diagnosed according to their medical history, clinical manifestations and EEG findings. Of the 69 patients, the clinical types were identified and 20 In the 71 patients diagnosed as epilepsy, there were 65 cases with complete sleep-waking cycle, 49 cases with waking discharge in waking period and 61 cases with discharging in sleeping period. Among them, NREMⅠ-Ⅱ 52 (85.2%), NREMⅠ-Ⅳ in 3 cases (4.9%) and NREWⅢ-Ⅳ in 6 cases (9.9%). Conclusion VEEG detection is helpful for the diagnosis of epilepsy and the determination of the type of clinical attack. Sleep monitoring is helpful for the detection of hippocampal waves, and the discharge of hippocampus mainly occurs in NREMⅠ-Ⅱ stage.