CO中毒继发癫痫的脑电图和经颅多普勒改变的关系研究

目的:探讨一氧化碳(Carbon monoxide,CO)中毒继发癫痫的经颅多普勒(Transcranial Doppler,TCD)和脑电图(Electroencephalogram,EEG)特征的关系。方法:对我院自2011年6月至2015年5月收治的145例CO中毒患者的临床资料和EEG、TCD特征进行检查,并分析其与继发癫痫的相关性。结果:145例CO中毒患者中,EEG结果显示正常患者93例(64.13%);异常患者52例(35.86%)。TCD正常患者90例(62.07%),异常55例(37.93%)。主要表现为颈内动脉系统血流动力学的改变,大脑前动脉流速与病情严重程度成正相关,TCD血流速度增加或减慢不对称,脑血流速度升高比率显著高于脑血流速度减低比率。无论在睡眠期还是清醒期EEG异常患者全导阵发性3.0~4.0Hz的棘慢波均存在放电。患者出现EEG、TCD异常与年龄、癫痫家族史、发热温度、持续时间、继发癫痫类型以及24h内发作次数有关。继发癫痫39例,占EEG异常患儿的75.00%,占TCD异常患儿的72.73%。继发癫痫患者中,15例额区放电日后发生发生癫痫14例(93.33%),19例枕区放电16例(84.21%)发生癫痫,13例Rolandic区放电8例(61.54%)发生癫痫,5例广泛性棘慢波者继发癫痫的有1例(20%)。结论:EEG、TCD检查异常的CO中毒患者中具有较高的继发癫痫的发病率,中枕区和额区阵发性异常放电者更容易继发癫痫。     

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。     

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。     

中老年人动脉硬化与心脏舒张期功能不全相关性的研究

目的:研究老年人动脉硬化与心脏舒张期功能不全的相关性.方法:将136例确诊为心脏舒张期功能不全的老年患者进行严重程度分级,与各组眼底动脉硬化病变的情况进行比较和分析.结果:在136例舒张期心功能不全的患者中,27例为轻度异常,无眼底动脉硬化患者占59.26％,有眼底动脉硬化患者占40.74％; 78例为中度异常,无眼底动脉硬化患者占34.62％,有眼底粥样硬化患者占65.38％;31例为重度异常,无眼底动脉硬化患者占19.35％,有眼底粥样硬化患者占80.65％.3组之间进行比较,差异有统计学意义,P＜0.01;136例舒张期心功能不全的患者中,共有87例患者存在不同程度的眼底动脉硬化病变.其中,11例轻度舒张功能不全患者中,眼底动脉硬化Ⅰ级占54.55％,眼底动脉硬化≥ Ⅱ级占45.45％;51例中度舒张功能不全患者中,眼底动脉硬化Ⅰ级占25.49％,眼底粥样硬化≥ Ⅱ级占74.51％;25例重度舒张功能不全患者中,眼底动脉硬化Ⅰ级占24.00％,眼底动脉硬化≥Ⅱ级占76.00％.3组之间进行比较,差异有统计学意义,P＜0.05.结论:老年动脉硬化患者与心脏舒张期功能不全情况存在着相关性,对临床诊断心功能不全有着重要的参考价值,值得进一步研究和探讨.     

阻塞性睡眠呼吸暂停的脑影像研究：来自静息态脑电和功能磁共振的证据

阻塞性睡眠呼吸暂停(obstructive sleep apnea, OSA)是一种常见的临床睡眠障碍,表现为上呼吸道在睡眠时反复阻塞,并导致睡眠片段化、间歇性低血氧等症状。本文回顾了针对OSA患者的静息态脑成像研究,包括静息态脑电(electroencephalography, EEG)和静息态功能磁共振成像(functional magnetic resonance imaging, fMRI)。在静息态EEG中,OSA主要表现为前额叶和中央区域δ波和θ波增加;而在静息态fMRI研究中,OSA患者在默认网络(default-mode network, DMN)、中央执行网络(central executive network, CEN)和突显网络(salience network, SN)等大尺度脑网络水平上存在改变。综合来自静息态EEG和静息态fMRI的研究,大量证据都共同指出OSA患者前额叶区域的活动异常,并且其异常活动强度与OSA严重程度相关,表明前额叶是OSA患者大脑功能受损的一个关键脑区。最后,本文从治疗效果、多模态数据采集、以及相关共病等方面对OSA未来研究方向进行了展望。     

三种抗癫痫药对癫痫患者脑电图的背景影响比较研究

目的:研究对比三种抗癫痫药(苯妥因钠、丙戊酸钠、卡马西平)对癫痫患者脑电图的背景影响。方法:选取我院于2009年3月至2011年2月收治的60例癫痫患者,随机分为苯妥因钠(PHT)、卡马西平(CBZ)和丙戊酸钠(SVP)组各20例,动态观察各组患者于治疗期间痫样波放电的频度和EEG背景的变化。结果:EEG痫样波放电的抑制率以SVP最为明显,而CBZ在EEG背景活动影响方面均比其他两组显著。结论:三种药物对癫痫波放电的抑制顺序是SVP>PHT>CBZ,SVP组明显优于其他两组。     

变应性鼻炎患者血清IL-17、IL-25及TNF-α水平表达及与病情严重程度的关系研究

目的:探讨变应性鼻炎(AR)患者血清白细胞介素-17(IL-17)、白细胞介素-25(IL-25)及肿瘤坏死因子-α(TNF-α)水平表达及与病情严重程度的关系。方法:选取2016年1月～2018年2月期间宜宾市第一人民医院耳鼻咽喉头颈外科收治的AR患者79例为AR组,参照世界卫生组织指定的《变应性鼻炎及其对哮喘的影响》中的标准将AR组患者分为轻度组29例、中度组34例、重度组16例,另选取同期我院收治的非AR患者30例为对照组。采用酶联免疫吸附试验检测所有患者的IL-17、IL-25及TNF-α水平,分别比较对照组与AR组以及不同病情严重程度患者IL-17、IL-25及TNF-α水平,采用Pearson相关性分析AR患者血清IL-17、IL-25及TNF-α相关性。结果:AR组血清IL-17、IL-25及TNF-α水平均显著高于对照组,组间比较差异有统计学意义(P0.05)。不同病情严重程度的AR患者血清IL-17、IL-25及TNF-α水平整体比较差异均有统计学意义(P0.05),中度组、重度组患者血清IL-17、IL-25及TNF-α水平均明显高于轻度组患者,且重度组高于中度组,差异有统计学意义(P0.05)。经Pearson相关性分析显示,AR患者血清IL-17、IL-25、TNF-α两两之间均呈正相关(P0.05)。结论:AR患者血清IL-17、IL-25及TNF-α呈现异常高表达,并随着患者疾病的加重而升高,且各因子存在一定的相关性,可考虑将其作为临床诊断AR的生物学指标。     

老年健康妇女脑电图的13～15Hz频带与智力相关

安静脑电图(EEG)的特征是否与智力有关?这是长期令人感兴趣的问题。EEG与智力之间的关系最初发现于儿童和一些发育迟缓或脑损伤受试者,他们的脑电图中有大量不正常的慢波和较低的α频率。正常人,EEG与智力年龄关系比较密切,即与α频率呈正相关,而与慢波(δ波和θ波)频率呈负相关;但与智商(IQ)并无明显相关性。由于智力和EEG均受年龄影响,如不控制年龄,可能会掩盖EEG与智力机能之间的关系。近年来由于运用傅立叶变换进行EEG频率的计算机定量测量,对EEG—IQ关系重新发生兴趣。     

小波能量评价EEG的不同成分对癫痫发作预报的价值

癫痫是一种严重危害人类健康的常见疾病,对癫痫发作进行预报具有重要的重要意义。通过对3例部分性继发全身性发作的癫痫病人在发作最长约30min的8导EEG进行小波分解,将EEG中的棘波、尖波成分与慢波成分分别突出到不同的尺度上,并计算相应尺度上这些成分的能量,考察这些不同成分在发作前的变化趋势。发现在发作前的若干分钟,8导EEG的慢波能量都有显著增大,而与棘波／尖波有关的快波能量基本上没有什么变化趋势,说明EEG慢波成分的增大对部分性继发全身性发作的预报具有重要价值,EEG的“慢波过大”可能是癫痫从发作间状态转变为发作的重要因素。     

Computerized tomography of the head in patients with epilepsy

A detection of structural changes in the brain of epileptic patients is of importance to the choice of therapeutical management. Incidence and character of lesions in CT-scans of the skull were analysed in the random group of epileptic patients. Normal areas in CT-scans were prevailing in young patients. Atrophic lesions to the brain increased with the patients' age and duration of the disease. Normal results were obtained in post-traumatic epilepsy and that of unknown etiology similarly to atrophic lesions whereas localized lesions were found in all patients with cerebral tumors. Partial epilepsy, especially of short duration, was characterized by high incidence of localized lesions. Normal EEG records were rare in patients with localized lesions detected with CT-scans whereas normal CT-scans may be related to abnormal EEG record. Presence of the localized lesions in some patients and atrophic areas did not limit clinical results of monitored therapy. CT-scanning of the skull should be performed in case of all patients with epilepsy even if there are no significant changes in EEG records or clinical status.     

Complexity of resting-state EEG activity in the patients with early-stage Parkinson’s disease

To investigate the abnormal brain activities in the early stage of Parkinson’s disease (PD), the electroencephalogram (EEG) signals were recorded with 20 channels from non-dementia PD patients (18 patients, 8 females) and age matched healthy controls (18 subjects, 8 females) during the resting state. Two methods based on the ordinal patterns of the recorded series, i.e., permutation entropy (PE) and order index (OI), were introduced to characterize the complexity of the cortical activities for two groups. It was observed that the resting-state EEG of PD patients showed lower PE and higher OI than healthy controls, which indicated that the early-stage PD caused the reduced complexity of EEG. We further applied two methods to determine the complexity of EEG rhythms in five sub-bands. The results showed that the gamma, beta and alpha rhythms of PD patients were characterized by lower PE and higher OI, i.e., reduced complexity, than healthy subjects. No significant differences were observed in theta or delta rhythms between two groups. The findings suggested that PE and OI were promising methods to detect the abnormal changes in the dynamics of EEG signals associated with early-stage PD. Further, such changes in EEG complexity may be the early markers of the cortical or subcortical dysfunction caused by PD.     

Neurological evaluation of chronic headache patients: is laboratory testing always necessary?

A review of records was conducted to examine the utility of doing routine laboratory testing (EEG and skull X rays) versus testing at the discretion of the attending neurologist on patients presenting for the nonpharmacological treatment of chronic headache. A total of 278 patients underwent neurological evaluation as part of a routine assessment prior to beginning self-regulatory treatment for headache. The first 112 subjects received routine laboratory tests of EEG and skull X-ray films. The second set of 166 subjects received laboratory tests only when deemed necessary by the neurologist. The rate of abnormal EEG in chronic headache sufferers was no greater than that found in the normal population, and only one or two potentially serious abnormalities were found on any laboratory test. A higher rate of abnormality was found when the CT scan was used in conjunction with clinical judgment. The majority of clients with abnormal laboratory tests (most of which were mildly abnormal) still saw substantial headache reduction with self-regulatory treatment for chronic headache. The authors suggest that routine laboratory testing may not be necessary and should be left to the discretion of a qualified neurologist.     

多发性抽动症的脑电图观察

目的:进一步探究脑电图对多发性抽动症患儿的辅助诊断价值。方法:本文对45例多发性抽动症患儿进行脑电图描记录,选择理想信号段进行分析。结果发现24例异常,异常率为53.3%。其中中度异常6例,占25%,脑波表现为在高幅δ、θ波长程阵发的背景上偶发尖波;轻度异常18例,占75%,表现背景脑波频率变慢,出现高幅δ、θ波及活动,伴短程出现;正常21例,较同年龄组的脑电图调节差,波形杂乱。结论:脑电图反映脑功能活动,通过计算机分析方法可提供更多信息,并且脑电图操作方便,无痛无创,易于被儿童接受,在多发性抽动症早期临床诊断中具有较高的应用价值。     

Processing of the electroencephalogram in cardiac surgery

The objective of this investigation was to find a method to automatically detect several types of abnormal EEG patterns which occurred during cardiac surgery. The EEGs were analyzed by means of several EEG processing and pattern recognition methods. It was found that a good classification into normal and abnormal EEG patterns was generally obtained if only two EEG features were used. The results of this investigation are of importance for implementing into a computer-based monitoring system for use during cardiac surgery.     

Fetal heart rate variability and brain stem injury after asphyxia in preterm fetal sheep

This study was undertaken to determine the mechanisms mediating changes in fetal heart rate variability (FHRV) during and after exposure to asphyxia in the premature fetus. Preterm fetal sheep at 0.6 of gestation (91 +/- 1 days, term is 147 days) were exposed to either sham occlusion (n = 10) or to complete umbilical cord occlusion for either 20 (n = 7) or 30 min (n = 10). Cord occlusion led to a transient increase in FHRV with abrupt body movements that resolved after 5 min. In the 30 min group there was a marked increase in FHRV in the final 10 min of occlusion related to abnormal atrial activity. After reperfusion, FHRV in both study groups was initially suppressed and progressively increased to baseline levels over the first 4 h of recovery. In the 20 min group this improvement was associated with return of normal EEG activity and movements. In contrast, in the 30 min group the EEG was abnormal with epileptiform activity superimposed on a suppressed background, which was associated with abnormal fetal movements. As the epileptiform activity resolved, FHRV fell and became suppressed for the remainder of the study. Histological assessment after 72 h demonstrated severe brain stem injury in the 30 min group but not in the 20 min group. In conclusion, during early recovery from asphyxia, epileptiform activity and associated abnormal fetal movements related to evolving neural injury can cause a confounding transient increase in FHRV, which mimics the normal pattern of recovery. However, chronic suppression of FHRV was a strong predictor of severe brain stem injury.     

Neurological evaluation of chronic headache patients: Is laboratory testing always necessary?

A review of records was conducted to examine the utility of doing routine laboratory testing (EEG and skull X rays) versus testing at the discretion of the attending neurologist on patients presenting for the nonpharmacological treatment of chronic headache. A total of 278 patients underwent neurological evaluation as part of a routine assessment prior to beginning self-regulatory treatment for headache. The first 112 subjects received routine laboratory tests of EEG and skull X-ray films. The second set of 166 subjects received laboratory tests only when deemed necessary by the neurologist. The rate of abnormal EEG in chronic headache sufferers was no greater than that found in the normal population, and only one or two potentially serious abnormalities were found on any laboratory test. A higher rate of abnormality was found when the CT scan was used in conjunction with clinical judgment. The majority of clients with abnormal laboratory tests (most of which were mildly abnormal) still saw substantial headache reduction with self-regulatory treatment for chronic headache. The authors suggest that routine laboratory testing may not be necessary and should be left to the discretion of a qualified neurologist.This research was supported in part by grants from NINCDS, NS-15235 and NS-23440.     

An aphasic syndrome in children

The paper presents case reports of nine children, all of whom had severe disturbances of language function of abrupt or gradual onset. Seizures occurred in seven of the children and all nine had EEG abnormalities.There was no apparent correlation between the seizures, the EEG changes and the aphasia. One patient had a brain biopsy performed at another hospital and the tissue was said to be normal. The cause of the abnormal language function is unknown. Five of the children failed to acquire normal speech subsequently. Three of the four children who made a complete recovery were treated with steroids.