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

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(P0.05)。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%(P0.05)。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%(P0.05)。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P0.05)。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。

Comparative Study of Video EEG and Conventional Electroencephalogram in Diagnosis and Localization of Epilepsy Children

ABSTRACT Objective: To compare the application value of video electroencephalogram (VEEG) and routine electroencephalo- gram (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 dis- charge of VEEG was significantly higher than that of REEG (P<0.05). The detection rate of clinical seizures of VEEG(48.75%) was sig- nificantly 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 tem- poral region, 4 cases, in occipital region, 4 cases, in central area and 3 cases, in the posterior occipital region. Conclusion: VEEG is supe- rior to REEG in the detection rate of epileptiform discharges and the detection rate of clinical seizures.and the effect of localization diag- nosis is much better, which is worthy of clinical application.