不同部位梗死后痴呆的脑电图表现差异分析

目的:探讨不同部位脑梗死导致血管性痴呆的脑电图表现差异,为血管性痴呆的诊断分类提供客观依据。方法:80例诊断血管性痴呆的患者根据影像学表现分为多灶梗死后痴呆和关键部位梗死后痴呆。入选患者均于饱餐后2小时给予常规18导脑电图检查,记录时间为30分钟以上。结果:1多灶梗死后痴呆多表现为α节律减慢,6-8Hz为主;波幅低,以20-25Uv为主,α波频率调节差、节律不规则。低波幅θ波出现者27例,占71.1%,出现于各导联,出现δ波者17例,占44.7%。2关键部位梗死后痴呆的患者中,正常为6例,占13%。异常者39例,占87%。EEG改变主要表现为α指数减少,节律以7-9Hz为主的患者28例,占71.8%。低波幅θ波出现者17例,以前额为主,占43.6%。39例患者未出现δ波。结论:不同部位梗死后血管性痴呆的脑电图表现不尽相同,可以为血管性痴呆的分类诊断提供客观依据。     

卡马西平与丙戊酸钠对儿童癫痫部分性发作脑电图的临床对照研究

目的:探究卡马西平与丙戊酸钠对儿童癫痫部分发作患儿发作脑电图影响,并实施组间对照研究。方法:选择2017年1月至2020年1月于我院接受治疗的81例癫痫部分性发作患儿为研究对象,按照其接受治疗的差异将其分为卡马西平组(40例)和丙戊酸钠组(41例),对比两组患儿接受药物治疗后脑电图以及脑电地形图变化情况。结果:(1)卡马西平组患儿接受治疗后脑电图检测显示间歇期痫样活动减少≥50%者占比高达67.50%(27/40),而丙戊酸钠组占比仅为43.90%(18/41),两组比较差异明显(P<0.05);(2)脑电背景活动变化比较显示,治疗后卡马西平组患儿α波无影响者占比65.00%,明显高于丙戊酸钠组36.59%,同时丙戊酸钠组患儿δ波数(20 s内)药物治疗后变化较卡马西平组更为明显;(3)脑电功率比较显示,卡马西平组患儿治疗后仅θ频段相对功率出现明显变化(P<0.05),但丙戊酸钠组患儿α频段相对功率、θ频段相对功率和θ频段绝对功率均出现明显变化(P<0.05)。结论:丙戊酸钠应用于儿童癫痫部分性发作时患儿脑电背景活动会明显变慢,甚至有出现间歇期痫样放电的风险,而卡马西平相对更为稳定,对患儿脑电图的影响更小,安全性更高。     

视频脑电图和影像学检查对继发性癫痫患儿的诊断价值研究

目的:研究视频脑电图(V-EEG)和影像学检查对继发性癫痫患儿的诊断价值。方法:选取从2014年3月到2017年4月在我院接受诊治的癫痫患儿168例纳入本次研究。分别对所有患儿实施V-EEG和核磁共振成像(MRI)诊断,比较两种方式的诊断价值。结果:168例患儿中,V-EEG监测到154例有异常的脑电信号,其中120例有痫样放电,V-EEG显示痫样放电分布在左侧和右侧导联的比例较双侧导联明显更高(P0.05),MRI检测结果显示,140例患儿有颅内有关结构的病变亦或是发育异常,28例未发现异常。168例患儿中,发作类型为单纯部分型者72例,占比最高,为42.86%;主要病因中,颅内感染的发作类型以全身型为主,占11.31%。脑梗塞的发作类型以单纯部分型为主,占8.33%。颅内软化灶的发作类型以复杂部分型为主,占6.55%。颅内肿瘤的发作类型以单纯部分型为主,占6.55%。MRI定位主要在单侧,其中左侧占38.10%,右侧占29.76%;而经V-EEG监测显示异常放电154例,占91.67%,其中颅内感染和脑梗塞以及颅内肿瘤和颅内软化灶的阳性检出比例最高,分别为24.40%,13.10%,11.90%和10.71%。V-EEG诊断灵敏度和特异度均明显高于MRI(P0.05)。结论:V-EEG较MRI对继发性癫痫患儿的诊断价值更高,能够更加准确地提供诊断结果数据,值得在临床诊治过程中给予推广和应用。     

脑电图检查对新生儿缺氧缺血性脑病的早期诊断及预后判断价值

目的:探讨脑电图检查对新生儿缺氧缺血性脑病早期诊断及预后判断的临床意价值。方法:本研究所选研究对象为我院2011年3月至2014年3月住院的91例出生后一天内的窒息新生儿,对其行脑电图检查,根据脑电图的检查结果将其分为四组,分别为正常组、轻度异常组、中度异常组、重度异常组。对上述四组患儿进行随访,时间点为出生后3个月、6个月,采用婴幼儿发育量表对患儿的智能发育进行测评,对各组智能发育的差异进行比较。结果:(1)91例患儿中,脑电图异常的有83例,异常率为91.21%,脑电图的异常程度与临床分度基本一致;(2)对患儿随访至3个月时,轻度、中度、重度异常组患儿的智力发育指数与运动发育指数的平均值与正常组患儿相比,具有显著差异(P0.05);(3)对患儿随访至6个月时,轻度异常组患儿的智力发育指数与运动发育指数的平均值与正常组患儿相比,无显著差异(P0.05)。中度、重度异常组患儿的智力发育指数与运动发育指数的平均值与正常组患儿相比,具有显著差异(P0.05)。结论:早期脑电图检查结果对新生儿缺氧缺血性脑病的早期诊断有利,为临床上早期干预提供了重要的参考依据。     

血浆miR-106b、miR-146a表达水平与癫痫患儿脑电图参数、Th17细胞和凋亡分子的相关性分析

摘要 目的：分析血浆miR-106b、miR-146a表达特点及其与脑电图参数、辅助性T细胞17（Th17）和凋亡分子的相关性以及诊断癫痫的价值。方法：选择2018年1月至2020年10月我院收治的癫痫患儿75例作为癫痫组,检测受试者血浆miR-106b、miR-146a表达,外周血Th17细胞占比、血清B细胞淋巴瘤/白血病-1（Bcl-1）、BCL2-Associated X蛋白（Bax）、Survivin、半胱氨酸天冬酰胺酶（Caspase-3）水平和脑电图参数α、β、 δ、θ波功率。分析miR-106b、miR-146a与Th17细胞占比、Bcl-1、Bax、Survivin、Caspase-3以及α、β、 δ、θ波功率的相关性,受试者工作特征（ROC）曲线分析miR-106b、miR-146a诊断癫痫的价值。结果：癫痫组血浆miR-106b、miR-146a表达、Th17细胞占比、Bax、Caspase-3水平高于对照组（P＜0.05）,α波功率、θ波功率、Bcl-1、Survivin水平低于对照组（P＜0.05）。miR-106b、miR-146a表达与Th17细胞占比、Bax、Caspase-3呈正相关（P＜0.05）,与α波功率、θ波功率、Bcl-1、Survivin呈负相关（P＜0.05）。联合miR-106b和miR-146a诊断癫痫的曲线下面积（AUC）为0.975,高于单独miR-106b和miR-146a诊断的0.884、0.835。结论：癫痫患儿血浆miR-146a、miR-106b表达增高,miR-146a、miR-106b高表达与脑电图异常、Th17细胞功能障碍以及神经细胞凋亡有关,miR-146a、miR-106b有望成为癫痫诊断的新生物学标志物。     

30例急性血吸虫病的脑电图分析

本文报道了30例急性血吸虫病的脑电图(EEG）资料分析。其中25例异常(占83．3％),主要表现为a波慢化、不规则或基本节律消失。25例中22例(占88％)的慢波以低。中波幅不规则θ波为主,分布以双侧中央区为多,额、枕区次之。EEG异常者,与病情严重程度相关,病情严重者EEG异常程度相对高。12例经治疗后,11例EEG有所改善。     

肺超声在获得性肺炎患儿诊断中的临床应用

目的:探索肺超声(LUS)在获得性肺炎(CAP)患儿诊断中的临床应用价值。方法:选取自2013年4月至2014年11月我院确诊为CAP的患儿95例,以腋前线、腋后线为界,将患儿肺脏分为前、后、侧三个区域,对所有患儿进行LUS检查,观察胸膜线、B线、肺实变程度及胸腔积液,并对支气管充气征进行检查。结果:95例CAP患儿经LUS检查后,诊断为阳性的有93例,阴性有2例,准确率为97.89%;CAP患儿的LUS的主要表现为肺泡-间质综合征、支气管充气症、胸膜线异常、胸腔积液;80例为综合表现(84.21%),15例为单一表现(15.79%)。结论:LUS诊断CAP患儿具有较高的准确率,结果安全可靠,可以应用于为临床诊断CAP。     

40例慢性脑型血吸虫病的脑电图分析

目的:了解脑型血吸虫病脑电图(EEG)的脑电活动状况,为临床诊断与治疗提供参考。方法:收集1997~2004年临床诊断为脑型血吸虫病的40例EEG资料,主要分析异常EEG的脑电活动状况与异常程度、临床分型及预后的关系。结果:31例出现不同程度的EEG异常改变,异常率为77.5%,其中癫痫性为70%;脑瘤型为100%。绝大部分EEG检查是患者经治疗后作的。治疗前后均作了EEG检查的仅9例。治疗前,9例均有不同程度异常,治疗后7例有不同程度改善,2例恢复正常。结论:EEG对脑型血吸虫病的诊断及预后的评价有参考价值。     

125例抽动障碍患儿动态脑电图及头颅核磁分析

目的:探讨抽动障碍患儿病情严重程度与其动态脑电图及头颅核磁改变的相关性。方法:对125例抽动障碍患儿进行耶鲁评分、动态脑电图以及头颅核磁检查。按抽动障碍患儿动态脑电图、头颅核磁检查结果将其分为正常组及异常组,比较不同组患儿的耶鲁评分;按抽动患儿耶鲁评分,将其分为轻、中、重症三组,比较不同组患儿的动态脑电及头颅核磁异常率,以探讨动障碍患儿病情严重程度与其动态脑电图及头颅核磁改变的相关性;对动态脑电图及头颅核磁检查均异常的抽动障碍患儿具体分析其临床特点。结果:1)动态脑电图异常组抽动障碍患儿之耶鲁评分高于正常组(P0.05),病情越重(耶鲁评分越高),动态脑电图异常率越高;2)头颅核磁异常组抽动患儿耶鲁评分亦高于正常组,但差异不具有统计学意义(P=0.077);3)动态脑电图及头颅核磁均异常患儿中,脑电异常以慢波为主,头颅核磁异常以脑室增宽或不对称及异常信号灶为主。结论:动态脑电图与抽动障碍患儿病情严重程度相关,可作为病情评估的客观标准之一;头颅核磁检查情况与抽动障碍严重程度相关性有待进一步研究证实。     

维生素E与左乙拉西坦对癫痫患者的临床疗效及血浆T-Aoc，MDA水平的影响

目的:探讨维生素E(VE)辅助左乙拉西坦(LEV)治疗癫痫的临床疗效及对患者血浆总抗氧化能力(T-Aoc)、丙二醛(MDA)水平的影响。方法:选取我院2013年6月~2015年9月收治的134例癫痫患者,随机分为两组。对照组予LEV治疗,观察组在此基础上给予VE治疗。记录比较两组临床疗效,治疗前后脑电图背景活动,血浆T-Aoc、MDA水平;并评价两组用药的安全性。结果:观察组总有效率为88.1%,较对照组(74.6%)明显升高(P0.05)。与治疗前相比,两组治疗后脑电图指标δ、θ波频率均明显增快(P0.05);α波频率均明显减慢(P0.05),且观察组治疗后脑电图指标改善效果均明显优于同期对照组(P0.05)。与治疗前比较,观察组血浆T-Aoc水平显著升高、MDA水平显著降低(P0.01),而对照组血浆T-Aoc水平有所上升、MDA水平略有下降,但差异无统计学意义(P0.05)。观察组不良反应发生率为10.4%,与对照组(7.5%)相比差异无统计学意义(P0.05)。结论:VE辅助LEV治疗癫痫能更有效降低发作频率,改善脑电图背景活动,平衡机体氧化/抗氧化系统,且安全性高。     

抽动秽语综合征遗传学研究

抽动秽语综合症(Gilles de la Tourette’s syndrome,GTS,TS)是一种慢性复杂性神经精神障碍,多起病于儿童期,以多发性运动性抽动伴不自主发声为主要临床表现,并伴多种并发症及神经行为障碍.目前已有大量关于TS遗传学研究报道,但其主要遗传学基础尚未鉴定.在此就抽动秽语综合征的遗传学研究做一介绍.     

Turner's syndrome: a qualitative and quantitative analysis of EEG background activity

Summary A qualitative and quantitative analysis was performed on the EEG background activity in 62 Danish girls and women with Turner's syndrome (30 with karyotype 45,X and 32 with other karyotypes) whose ages ranged from 6 to 47 years (87% were aged 15 years or more) and age-matched controls. The pooled data and a case-control study showed characteristic features in Turner subjects, including: (1) more rapid frequency, larger amplitude and lower amount of alpha waves, (2) higher amount of theta waves, (3) larger amplitude and higher amount of delta waves and (4) larger amplitude and higher amount of beta waves than in controls. These findings in Turner subjects were more pronounced in the left hemisphere, and more typical, except for the amplitude in alpha waves, in Turner subjects with 45,X than in those with other karyotypes. The effects of advancing age on the EEG background activity observed in controls — including more rapid frequency, decreased amplitude and amount of alpha waves, increased amount of theta and delta waves, and increased amount of beta waves, particularly after 35 years of age — were found in some Turner subjects. Hemispheric differences with higher activity (i.e. more rapid frequency, larger amplitude and higher amount of alpha waves, particularly at Fp₁ and F₃, and, inversely, lower amount of theta or delta waves) at P₃, T₃, T₅ and O₂ than at the opposite side were found in many Turner subjects. However, these findings were not specific for Turner subiects, since the same hemispheric differences were also observed much more markedly in controls. These topographic distributions with hemispheric differences did not provide evidence for hypofunction in the temporo-parieto-occipital tertiary area of the right hemisphere in Turner subjects, though this had been expected on the basis of neuropsychological examinations. Our findings, including transiently appearing brain hypofunction at the parietal, temporal and occipital areas, most often in the right hemisphere, indicate a relationship between the chromosomal constitution 45,X and EEG background activity. They suggest the presence of functional brain disturbance in the thalamus and in the ascending reticular activating system, which tends to disturb the thalamo-cortical circuit. Further studies, including topographic and sequential power spectrum analysis of EEG background activity, 24-h continuous EEG recording, blood flow studies (positron computerized tomography) and neuropathological examination, may be needed.Tables I-VI are available on request     

Potentiation of haloperidol catalepsy by microinjections of nicotine into the striatum or pons in rats

It was reported that systemic administration of nicotine in rats potentiated the cataleptogenic effect of haloperidol. Moreover, addition of nicotine to the treatment with haloperidol in patients suffering from the Gilles de la Tourette's syndrome resulted in reduction in frequency and severity of tics. In the present article we report results of experiments aimed at investigating the role of striatum and pontine reticular formation in the synergistic relations between the two drugs. Nicotine was microinjected directly into the striatum or pontine reticular formation of rats and its cataleptogenic effects were studied when given alone or in combination with systemical injections of haloperidol. It was found that nicotine has cataleptogenic effects when microinjected both into the striatum and pontine reticular formation. The synergism between the two drugs occurred both after microinjections into the striatum and pontine reticular formation.     

Parental generalized EEG alpha activity predisposes to spike wave discharges in offspring

Familial and twin studies have shown that the individual variability of the normal human electroencephalogram (EEG) is largely genetically determined. In epileptology, these genetic parameters of the EEG background activity are almost totally neglected. The aim of the present study has been to investigate whether a special genetic type of background activity might be related to the pathogenesis of epilepsy. EEG recordings of parents of 257 epileptic children were evaluated retrospectively. Some 156 healthy adults served as controls. Special attention was paid to alpha activity extending to the frontal region, both in bipolar and in referential recordings (Alpha I). Alpha I was found significantly more often in parents of children with primary generalized epilepsy (18%) compared with parents of children with focal epilepsy (8%) or controls (9%). In a second step, parental EEGs of children with different EEG patterns associated with epilepsy were studied. Alpha I was found significantly more often in parents of children with focal sharp waves and generalized spikes and waves (26%) than in parents of probands with focal sharp waves without additional generalized spikes and waves (8%) or in controls (9%). Parents of probands with theta rhythms and spikes and waves had alpha I significantly more often (18%) than parents of probands with theta rhythms without additional spikes and waves (8%) or controls (9%). The findings reveal a clear correlation between the type of EEG background activity in parents and the EEG characteristics in their children, thus pointing to common mechanisms.     

A new gene for Tourette's syndrome: a window into causal mechanisms?

Gilles de la Tourette syndrome (GTS) is a neurodevelopmental disorder characterized by impairing motor-vocal tics. Locating genetic loci by associating the phenotype with DNA translocations, inversions, gain or losses, State et al. identified SLITRK1 as a candidate gene in an individual with GTS and inv(13) (q31.1; q33.1). This gene was also associated with abnormal axonal-dendritic development in embryonic mouse cells. Although SLITRK1 is not a major causal gene for GTS, it can shed light on our understanding of the gene-based neural correlates of this disease.     

Current theories on the etiology and treatment of Gilles de la Tourette's disease]

Gilles de la Tourette syndrome is a condition marked by: (1) onset usually in childhood and adolescence, i.e. between 2 and 15 years of life; (2) violent facial tics and echolalia; (3) increased excitability and apathy; (4) progressive increase in symptoms intensity; (5) chronic course. This syndrome is threefold more frequent in men than in women. None hypothesis concerning its etiopathogenesis (genetic, organic, organic-functional, psychomotor, and mixed) does explain its origin. Many cases respond with some degree of relief to neuroleptics, carbamazepine, clonidine, and glucocorticosteroids. Neurosurgery and psychotherapy are also of value. Haloperidol is commonly considered the most effective in this syndrome.     

Complex segregation analysis of Gilles de la Tourette syndrome: further evidence for a major locus mode of transmission

A sample of 35 published pedigrees of Gilles de la Tourette syndrome is studied using complex segregation analysis with pointers. Results indicate the presence of a rare, semidominant, incompletely penetrant allele leading to affection. This result is consistent with that previously reported by Comings et al. on a larger, independent sample.     

肺脏超声对新生儿呼吸窘迫综合征的诊断价值及肺超声评分的评估价值分析

目的:探讨肺脏超声对新生儿呼吸窘迫综合征(NRDS)的诊断价值,并分析肺超声评分的临床应用价值。方法:本研究选择2017年5月至2018年5月于我院确诊的NRDS患儿45例作为观察组,选择同期于我院就诊的非肺病患儿45例作为对照组,所有患儿均行肺脏超声检查。分析NRDS患儿肺脏超声特征性征象,比较肺脏超声对两组患儿各种征象的检出率,分析肺脏超声对NRDS的诊断价值,比较两组肺超声评分。结果:NRDS患儿全部存在肺实质征象,超声下肺组织回声呈肝样伴支气管充气征,轻度的NRDS患儿于肺脏超声下表现为局灶性的肺实质,且支气管充气征不明显;重度的NRDS患儿于肺脏超声下表现为肺实质范围的进一步扩大,且支气管充气征随病情的加重而愈发明显。观察组肺实质、胸膜线异常、A线消失、弥漫性肺水肿、支气管充气征等征象的检出率显著高于对照组(P0.05),两组B线存在征象的检出率比较无统计学差异(P0.05)。肺实质、胸膜线异常和A线消失三种特征征象同时存在时对NRDS诊断的灵敏度和特异性均为100.00%,肺实质、胸膜线异常和支气管充气征三种特征征象同时存在时对NRDS诊断的灵敏度为80.00%,特异性为100.00%。观察组双肺、左肺、右肺、双侧肺、双肺底肺超声评分均高于对照组(P0.05)。结论:肺脏超声对NRDS的诊断价值较高,且肺超声评分可以评估NRDS患儿的病情严重程度,有助于指导患儿的治疗。     

Chromosomes in the Cornelia de Lange syndrome

Summary This paper summarizes previous chromosomal studies in patients with the Cornelia de Lange syndrome showing abnormal karyotypes. We report on 45 cases of the Cornelia de Lange syndrome clinically examined by one of us (B. B.) and chromosomally studied using several different methods. Two abnormal karyotypes were found: a girl with a 45,X karyotype and a boy with a (13q14q) translocation which was also found in his phenotypically normal mother and maternal grandmother. Because of recent reports of the duplication 3q syndrome and Comelia de Lange-like phenotypes, prometaphase chromosomes were studied in 31 patients. All karyotypes were normal. As there was an excess of boys among the younger patients, special examination for the fragile site on X(q28) was carried out. This abnormality was not found. Even though no patients with the dup(3q) syndrome were found among the Cornelia de Lange patients, chromosome studies are recommended especially in connection with genetic counselling. A recurrence rate of 2–5% must still be considered for the Cornelia de Lange syndrome.     

Genetic analysis of Tourette syndrome suggesting major gene effect.

Data on Gilles de la Tourette syndrome are analyzed by multiple threshold models in inheritance that incorporate sex effect. The polygenic-multifactorial model is rejected. Single major locus inheritance can account for the data, although many of the occurrences of Tourette are due to nongenetic phenocopies. In both models, males and females share a common genetic environmental liability, but the less prevalent sex, that is, females, has a higher genetic loading for the disorder. The predicted population prevalences in the single major locus model are 2.3% for males and 0.8% for females. The implications for genetic and biological research in Tourette syndrome are discussed.