视频脑电图与常规脑电图在癫痫患儿诊断和定位中的应用价值对比研究
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摘要
目的:比较视频脑电图(VEEG)与常规脑电图(REEG)在癫痫患儿诊断和定位中的应用价值,为癫痫诊断提供依据。方法:对2014年1月~2016年12月间本院收治的有临床症状拟诊断为癫痫的102例患儿的临床资料进行回顾性分析,比较VEEG与REEG两种方法痫样放电检出率、临床发作检出率、睡眠期检出率以及痫灶定位中的诊断价值。结果:102例患儿中,VEEG检测到痫样放电80例,痫样放电检出率为78.43%,REEG检测到痫样放电42例,痫样放电检出率为41.18%,VEEG痫样放电检出率显著高于REEG(P<0.05)。VEEG临床发作检出率为48.75%,显著高于REEG临床发作检出率的14.29%(P<0.05)。VEEG检测出睡眠期痫样放电检出率为46.25%,高于觉醒期痫样放电检出率的12.50%(P<0.05)。VEEG睡眠期各电图时相痫样放电检出率比较,组间差异均有统计学意义(均P<0.05)。根据VEEG确定39例癫痫患儿痫样放电起源部位为额区9例、颞区10例、额颞区9例、枕区4例、中央区4例、颞枕后区3例。结论:VEEG对癫痫患儿的脑部痫样放电检出率和临床发作检出率均明显优于REEG,同时定位诊断效果更优,值得临床推广应用。
Objective: To compare the application value of video electroencephalogram(VEEG) and routine electroencephalogram(REEG) in the diagnosis and localization of children with epilepsy, and to provide evidence for the diagnosis of epilepsy. Methods:The clinical data of 102 children with clinical symptoms, who were diagnosed as epilepsy and treated in First Hospital of Qinhuangdao from January 2014 to December 2016, were analyzed retrospectively. The detection rate of epileptiform discharges, clinical seizures,sleep and the diagnostic value of localization of epilepsy were compared between the two methods of VEEG and REEG. Results: Among the 102 cases, 80 cases of epileptiform discharge were detected by VEEG, epileptiform discharge detection rate was 78.43%; 42 cases of epileptiform discharges were detected by REEG, epileptiform discharge detection rate was 41.18%, the detection rate of epileptiform discharge of VEEG was significantly higher than that of REEG(P<0.05). The detection rate of clinical seizures of VEEG(48.75%) was significantly higher than that(14.29%) of REEG(P<0.05). The detection rate of epileptiform discharges in sleep period of VEEG(46.25%)was significantly higher than that(12.50%) in waking period of VEEG(P<0.05). There were significant differences in the epileptiform discharges detection rates between sleep stage and electrocardiogram(P<0.05). According to the VEEG, among the 39 children with epilepsy, there were 9 cases of epileptiform discharge located in frontal region, 10 cases, in temporal region, 9 cases, in frontal and temporal region, 4 cases, in occipital region, 4 cases, in central area and 3 cases, in the posterior occipital region. Conclusion: VEEG is superior to REEG in the detection rate of epileptiform discharges and the detection rate of clinical seizures.and the effect of localization diagnosis is much better, which is worthy of clinical application.
Objective: To compare the application value of video electroencephalogram(VEEG) and routine electroencephalogram(REEG) in the diagnosis and localization of children with epilepsy, and to provide evidence for the diagnosis of epilepsy. Methods:The clinical data of 102 children with clinical symptoms, who were diagnosed as epilepsy and treated in First Hospital of Qinhuangdao from January 2014 to December 2016, were analyzed retrospectively. The detection rate of epileptiform discharges, clinical seizures,sleep and the diagnostic value of localization of epilepsy were compared between the two methods of VEEG and REEG. Results: Among the 102 cases, 80 cases of epileptiform discharge were detected by VEEG, epileptiform discharge detection rate was 78.43%; 42 cases of epileptiform discharges were detected by REEG, epileptiform discharge detection rate was 41.18%, the detection rate of epileptiform discharge of VEEG was significantly higher than that of REEG(P<0.05). The detection rate of clinical seizures of VEEG(48.75%) was significantly higher than that(14.29%) of REEG(P<0.05). The detection rate of epileptiform discharges in sleep period of VEEG(46.25%)was significantly higher than that(12.50%) in waking period of VEEG(P<0.05). There were significant differences in the epileptiform discharges detection rates between sleep stage and electrocardiogram(P<0.05). According to the VEEG, among the 39 children with epilepsy, there were 9 cases of epileptiform discharge located in frontal region, 10 cases, in temporal region, 9 cases, in frontal and temporal region, 4 cases, in occipital region, 4 cases, in central area and 3 cases, in the posterior occipital region. Conclusion: VEEG is superior to REEG in the detection rate of epileptiform discharges and the detection rate of clinical seizures.and the effect of localization diagnosis is much better, which is worthy of clinical application.
引文
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[15]王晓雨,陈静,郑帼,等.首次治疗儿童失神癫痫短期预后的评估[J].中华实用儿科临床杂志,2017,32(5):369-373Wang Xiao-yu,Chen Jing,Zheng Guo,et al.The short-term prognostic evaluation in first-drug therapy outcome in children with absence epilepsy[J].Journal of Applied Clinical Pediatrics,2017,32(5):369-373
[16]覃君德,龚彩芬.睡眠中发作症状的脑电图特征及其与睡眠分期的关系[J].临床和实验医学杂志,2015,14(8):690-692Qin Jun-de,Gong Cai-fen.Study on the characteristics of EEG features in onset of symptoms during sleep and its relationship with sleep staging[J].Journal of Clinical and Experimental Medicine,2015,14(8):690-692
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[19]Dharmadhikari AS,Sinha VK.Psychiatric Comorbidity in Children with?Epilepsy:A Cross-sectional 5 Years Rural Prevalence Study[J].J Neurosci Rural Pract,2017,8(2):179-184
[20]Wen T,Zhang Z.Effective and extensible feature extraction method using genetic algorithm-based frequency-domain feature search for epileptic EEG multiclassification[J].Medicine(Baltimore),2017,96(19):e6879
[21]Perry MS,Bailey L,Freedman D,et al.Coregistration of multimodal imaging is associated with favourable two-year seizure outcome after paediatric epilepsy surgery[J].Epileptic Disord,2017,19(1):40-48
[22]秦晓云,窦长武,张占普,等.动态脑电图监测癫痫患者的临床意义[J].西部医学,2016,28(3):358-360,364Qin Xiao-yun,Dou Chang-wu,Zhang Zhan-pu,et al.Clinical significance of dynamic EEG monitoring in patients with epilepsy[J].Medical Journal of West China,2016,28(3):358-360,364
[23]Chen Z,An Y,Zhao B,et al.The value of resting-state functional magnetic resonance imaging for detecting epileptogenic zones in patients with focal epilepsy[J].PLo S One,2017,12(2):e0172094
[24]Steimer A,Müller M,Schindler K.Predictive modeling of EEG time series for evaluating surgery targets in epilepsy patients[J].Hum Brain Mapp,2017,38(5):2509-2531
[25]Kim MJ,Yum MS,Kim EH,et al.An interictal EEG can predict the outcome of vagus nerve stimulation therapy for children with intractable epilepsy[J].Childs Nerv Syst,2017,33(1):145-151
[26]Zhang W,Liu X,Zuo L,et al.Ipsiversive ictal eye deviation in inferioposterior temporal lobe epilepsy-Two SEEG cases report[J].BMC Neurol,2017,17(1):38
[27]Sanz-Garcia A,Vega-Zelaya L,Pastor J,et al.When does post-ictal period start in temporal lobe epilepsy A quantitative EEG perspective[J].Rev Neurol,2017,64(8):337-346
[28]Horváth A,Szücs A,Barcs G,et al.Sleep EEG Detects Epileptiform Activity in Alzheimer's Disease with High Sensitivity[J].J Alzheimers Dis,2017,56(3):1175-1183
[29]Hupalo M,Wojcik R,Jaskolski DJ.Intracranial video-EEG monitoring in presurgical evaluation of patients with refractory epilepsy[J].Neurol Neurochir Pol,2017,51(3):201-207
[30]Jayabal V,Pillai A,Sinha S,et al.Role of magnetoencephalography and stereo-electroencephalography in the presurgical evaluation in patients with drug-resistant epilepsy[J].Neurol India,2017,65(Supplement):S34-S44
[2]Cao D,Badoe E,Zhu Y,et al.First Application of Ketogenic Diet on a Child With Intractable Epilepsy in Ghana[J].Child Neurol Open,2015,2(3):2329048X15604593
[3]Zarcone D,Corbetta S.Shared mechanisms of epilepsy,migraine and affective disorders[J].Neurol Sci,2017,38(Suppl 1):73-76
[4]刘鑫桐,于盼盼,孙觊,等.癫痫发生过程中免疫学相关机制的研究进展[J].中风与神经疾病杂志,2017,34(2):179-182Liu Xin-tong,Yu Pan-pan,Sun Ji,et al.Advances in immunological related mechanisms in epilepsy[J].Journal of Apoplexy and Nervous Diseases,2017,34(2):179-182
[5]覵abuz-Roszak B,Pyrtek S,Adamczyk K,et al.Psychometric and neurophysiological assessment of cognitive functions in patients with epilepsy[J].Wiad Lek,2015,68(3 pt 2):341-346
[6]KrámskáL,Vojtěch Z,Lukavsk J,et al.Five-Year Neuropsychological Outcome after Stereotactic Radiofrequency Amygdalohippocampectomy for Mesial Temporal Lobe Epilepsy:Longitudinal Study[J].Stereotact Funct Neurosurg,2017,95(3):149-157
[7]Sauro KM,Wiebe N,Macrodimitris S,et al.Quality and safety in adult epilepsy monitoring units:A systematic review and meta-analysis[J].Epilepsia,2016,57(11):1754-1770
[8]Hlebokazov F,Dakukina T,Ihnatsenko S,et al.Treatment of refractory epilepsy patients with autologous mesenchymal stem cells reduces seizure frequency:An open label study[J].Adv Med Sci,2017,62(2):273-279
[9]王晖,肖昭扬,高琴琴,等.双孔钾通道TREK-1结构、分布、调控因素及其抗癫痫作用的研究进展[J].现代生物医学进展,2014,14(12):2356-2359Wang Hui,Xiao Zhao-yang,Gao Qin-qin,et al.Research Progress about the Molecular Structure and Tissue Distribution and Regulation of TREK-1 and the Role of Anti-epileptic[J].Progress in Modern Biomedicine,2014,14(12):2356-2359
[10]Noel JP,Kurela L,Baum SH,et al.Multisensory temporal function and EEG complexity in patients with epilepsy and psychogenic nonepileptic events[J].Epilepsy Behav,2017,70(Pt A):166-172
[11]Jin B,So NK,Wang S.Advances of Intracranial Electroencephalography in Localizing the Epileptogenic Zone[J].Neurosci Bull,2016,32(5):493-500
[12]De Marchi LR,Corso JT,Zetehaku AC,et al.Efficacy and safety of a video-EEG protocol for genetic generalized epilepsies[J].Epilepsy Behav,2017,70(Pt A):187-192
[13]Jin B,Wang S,Yang L,et al.Prevalence and predictors of subclinical seizures during scalp video-EEG monitoring in patients withepilepsy[J].Int J Neurosci,2017,127(8):651-658
[14]Hussain L,Aziz W,Alowibdi JS,et al.Symbolic time series analysis of electroencephalographic(EEG)epileptic seizure and brain dynamics with eye-open and eye-closed subjects during resting states[J].J Physiol Anthropol,2017,36(1):21
[15]王晓雨,陈静,郑帼,等.首次治疗儿童失神癫痫短期预后的评估[J].中华实用儿科临床杂志,2017,32(5):369-373Wang Xiao-yu,Chen Jing,Zheng Guo,et al.The short-term prognostic evaluation in first-drug therapy outcome in children with absence epilepsy[J].Journal of Applied Clinical Pediatrics,2017,32(5):369-373
[16]覃君德,龚彩芬.睡眠中发作症状的脑电图特征及其与睡眠分期的关系[J].临床和实验医学杂志,2015,14(8):690-692Qin Jun-de,Gong Cai-fen.Study on the characteristics of EEG features in onset of symptoms during sleep and its relationship with sleep staging[J].Journal of Clinical and Experimental Medicine,2015,14(8):690-692
[17]Vukojevi M,Cvitkovi T,Splavski B,et al.Prevalence of Intellectual Disabilities and Epilepsy in Different Forms of Spastic Cerebral Palsy in Adults[J].Psychiatr Danub,2017,29(Suppl 2):111-117
[18]Hawkins NA,Anderson LL,Gertler TS,et al.Screening of conventional anticonvulsants in a genetic mouse model of epilepsy[J].Ann Clin Transl Neurol,2017,4(5):326-339
[19]Dharmadhikari AS,Sinha VK.Psychiatric Comorbidity in Children with?Epilepsy:A Cross-sectional 5 Years Rural Prevalence Study[J].J Neurosci Rural Pract,2017,8(2):179-184
[20]Wen T,Zhang Z.Effective and extensible feature extraction method using genetic algorithm-based frequency-domain feature search for epileptic EEG multiclassification[J].Medicine(Baltimore),2017,96(19):e6879
[21]Perry MS,Bailey L,Freedman D,et al.Coregistration of multimodal imaging is associated with favourable two-year seizure outcome after paediatric epilepsy surgery[J].Epileptic Disord,2017,19(1):40-48
[22]秦晓云,窦长武,张占普,等.动态脑电图监测癫痫患者的临床意义[J].西部医学,2016,28(3):358-360,364Qin Xiao-yun,Dou Chang-wu,Zhang Zhan-pu,et al.Clinical significance of dynamic EEG monitoring in patients with epilepsy[J].Medical Journal of West China,2016,28(3):358-360,364
[23]Chen Z,An Y,Zhao B,et al.The value of resting-state functional magnetic resonance imaging for detecting epileptogenic zones in patients with focal epilepsy[J].PLo S One,2017,12(2):e0172094
[24]Steimer A,Müller M,Schindler K.Predictive modeling of EEG time series for evaluating surgery targets in epilepsy patients[J].Hum Brain Mapp,2017,38(5):2509-2531
[25]Kim MJ,Yum MS,Kim EH,et al.An interictal EEG can predict the outcome of vagus nerve stimulation therapy for children with intractable epilepsy[J].Childs Nerv Syst,2017,33(1):145-151
[26]Zhang W,Liu X,Zuo L,et al.Ipsiversive ictal eye deviation in inferioposterior temporal lobe epilepsy-Two SEEG cases report[J].BMC Neurol,2017,17(1):38
[27]Sanz-Garcia A,Vega-Zelaya L,Pastor J,et al.When does post-ictal period start in temporal lobe epilepsy A quantitative EEG perspective[J].Rev Neurol,2017,64(8):337-346
[28]Horváth A,Szücs A,Barcs G,et al.Sleep EEG Detects Epileptiform Activity in Alzheimer's Disease with High Sensitivity[J].J Alzheimers Dis,2017,56(3):1175-1183
[29]Hupalo M,Wojcik R,Jaskolski DJ.Intracranial video-EEG monitoring in presurgical evaluation of patients with refractory epilepsy[J].Neurol Neurochir Pol,2017,51(3):201-207
[30]Jayabal V,Pillai A,Sinha S,et al.Role of magnetoencephalography and stereo-electroencephalography in the presurgical evaluation in patients with drug-resistant epilepsy[J].Neurol India,2017,65(Supplement):S34-S44