部分剥夺睡眠在癫痫患儿动态脑电图检测中的应用
|
摘要
目的:探讨部分剥夺睡眠是否提高动态脑电图(dEEG)对癫痫的检出率。方法:对2017年3月至2018年8月本院68例拟诊为癫痫患儿先行常规脑电图(r EEG)描记和dEEG检测,2周后对这些患儿采取部分剥夺睡眠后再行r EEG描记和dEEG检测。比较r EEG描记与dEEG检测在未剥夺与部分剥夺睡眠条件下的检出率。结果:68例拟诊癫痫患儿未剥夺睡眠和部分剥夺睡眠两个时期的r EEG描记与dEEG检测相比,非特异性异常检出率差异均无统计学意义(P>0. 05),但痫样放电和总异常检出率差异均有统计学意义(P<0. 05)。在痫样放电、非特异性异常和总异常检出率方面,未剥夺睡眠时与部分剥夺睡眠时初始30 min r EEG描记结果相比,差异均无统计学意义(P> 0. 05);而此后的dEEG检测结果显示,两个时期虽然非特异性异常检出率比较差异无统计学意义(P> 0. 05),但痫样放电及总异常检出率比较差异均有统计学意义(P <0. 05)。结论:部分剥夺睡眠时在初始30 min对癫痫患儿的r EEG描记结果无明显影响,但会提高dEEG检测对痫样放电和总异常的检出率,值得临床推广。
Objective: To investigate whether partial sleep deprivation increases the detection rate of epilepsy in children by dynamic electroencephalogram( dEEG). Methods: Sixty-eight cases of children with suspected epilepsy in our hospital from March 2017 to August 2018 were firstly detected by routine electroencephalogram( r EEG) and d EEG. Two weeks later,all children were deprived of 3-5 hours of sleep before r EEG and d EEG.Detection rates of r EEG and dEEG were compared between normal sleep and partial sleep deprivation. Results:There was no significant difference in the detection rate of non-specific abnormality between r EEG and d EEG in 68 suspected epileptic children without sleep deprivation and partial sleep deprivation( P > 0. 05),and there was no significant difference between the two groups( P > 0. 05). But there was a significant difference between epileptiform discharge and total abnormal detection rate( P < 0. 05). In terms of epileptiform discharge,nonspecific abnormality and total abnormal detection rate,there was no significant difference between sleep deprivation and partial sleep deprivation in r EEG recording results( P > 0. 05),but there was no significant difference between non-sleep deprivation and partial sleep deprivation( P > 0. 05). The results of dEEG showed that although there was no significant difference in non-specific abnormal detection rate between the two periods,there was a significant difference in epileptiform discharge and total abnormal detection rate between the two periods( P <0. 05). Conclusion: Partial deprivation of sleep does not affect the r EEG tracing results of the epileptic children,but improves the detection rate of the dEEG detection on the epileptiform discharge and the total abnormality,and is worthy of clinical popularization.
Objective: To investigate whether partial sleep deprivation increases the detection rate of epilepsy in children by dynamic electroencephalogram( dEEG). Methods: Sixty-eight cases of children with suspected epilepsy in our hospital from March 2017 to August 2018 were firstly detected by routine electroencephalogram( r EEG) and d EEG. Two weeks later,all children were deprived of 3-5 hours of sleep before r EEG and d EEG.Detection rates of r EEG and dEEG were compared between normal sleep and partial sleep deprivation. Results:There was no significant difference in the detection rate of non-specific abnormality between r EEG and d EEG in 68 suspected epileptic children without sleep deprivation and partial sleep deprivation( P > 0. 05),and there was no significant difference between the two groups( P > 0. 05). But there was a significant difference between epileptiform discharge and total abnormal detection rate( P < 0. 05). In terms of epileptiform discharge,nonspecific abnormality and total abnormal detection rate,there was no significant difference between sleep deprivation and partial sleep deprivation in r EEG recording results( P > 0. 05),but there was no significant difference between non-sleep deprivation and partial sleep deprivation( P > 0. 05). The results of dEEG showed that although there was no significant difference in non-specific abnormal detection rate between the two periods,there was a significant difference in epileptiform discharge and total abnormal detection rate between the two periods( P <0. 05). Conclusion: Partial deprivation of sleep does not affect the r EEG tracing results of the epileptic children,but improves the detection rate of the dEEG detection on the epileptiform discharge and the total abnormality,and is worthy of clinical popularization.
引文
[1]贾建平.神经病学[M]. 7版.北京:人民卫生出版社,2013:297.
[2]LIAMSUWAN S,GRATTAN-SMITH P,FAGAN E,et al. The value of partial sleep deprivation as a routine measure in pediatric electroencephalography[J]. J Child Neurol,2000,15(1):26-29.
[3]刘晓燕.临床脑电图学[M]. 7版.北京:人民卫生出版社,2013:297.
[4]陈伟,郭常利,肖以磊.癫痫持续状态的临床及脑电图特征[J/OL].中华临床医师杂志(电子版),2013,7(2):597-600.
[5]SANDER J,SHAMDEEN M G,GOTTSCHLING S,et al. Melatonin does not influence sleep deprivation electroencephalogram recordings in children[J]. Eur J Pediatr,2012,171(4):675-679.
[6]沈鼎烈.安定对癫痫患者脑电图的影响初探[J].脑电图学与神经精神疾病杂志,1989,5(3):129.
[7]沈鼎烈.临床癫痫学[M].上海:上海科学技术出版社,1994:178-189.
[8]许晓燕.动态脑电图在儿童癫痫诊断中的价值[J].中外医学研究,2018,8(14):101-103.
[9]李振光.睡眠视频脑电监测对癫痫诊断及疗效评估的价值[J].现代电生理学杂志,2009,16(2):77.
[2]LIAMSUWAN S,GRATTAN-SMITH P,FAGAN E,et al. The value of partial sleep deprivation as a routine measure in pediatric electroencephalography[J]. J Child Neurol,2000,15(1):26-29.
[3]刘晓燕.临床脑电图学[M]. 7版.北京:人民卫生出版社,2013:297.
[4]陈伟,郭常利,肖以磊.癫痫持续状态的临床及脑电图特征[J/OL].中华临床医师杂志(电子版),2013,7(2):597-600.
[5]SANDER J,SHAMDEEN M G,GOTTSCHLING S,et al. Melatonin does not influence sleep deprivation electroencephalogram recordings in children[J]. Eur J Pediatr,2012,171(4):675-679.
[6]沈鼎烈.安定对癫痫患者脑电图的影响初探[J].脑电图学与神经精神疾病杂志,1989,5(3):129.
[7]沈鼎烈.临床癫痫学[M].上海:上海科学技术出版社,1994:178-189.
[8]许晓燕.动态脑电图在儿童癫痫诊断中的价值[J].中外医学研究,2018,8(14):101-103.
[9]李振光.睡眠视频脑电监测对癫痫诊断及疗效评估的价值[J].现代电生理学杂志,2009,16(2):77.