探讨长程视频脑电监测在癫痫诊断中的应用

探讨长程视频脑电监测在癫痫诊断中的应用
摘要：目的研究分析长程视频脑电监测（VEEG）应用在癫痫诊断中的临床效果及实际意义，评价其临床应用价值。方法此次研究的对象是选取2013年11月～2015年12月在本院行长程视频脑电图监测的174例患者，将其临床资料进行回顾性分析，并对患者2、6、12、24 h的脑电图监测结果进行分析，了解临床发作和癫痫样异常放电的关联。结果174患者中，共监测到115例出现临床发作现象，105例诊断为癫痫，56例无法明确诊断是否属于癫痫，另13例诊断为非癫痫患者。59例无临床发作的患者中，发作间期异常放电39例，癫痫不能排除；余下20例始终无异常放电，不能诊断是否为癫痫。在174例患者中，144例异常放电，其中12例是在清醒期，50例在睡眠期，还有82例是清醒期、睡眠期均同时出现异常放电。此外，105例确诊患者中，发作前均有异常脑电图改变，同时根据监测时相发现2 h时相和6 h时相的临床发作率比较，差异有统计学意义（P<0.05）。6 h时相和12 h时相的临床发作率比较，差异有统计学意义（P<0.05）。6 h时相和24 h时相的临床发作率比较，差异无统计学意义（P>0.05）。四个时相的异常放电率比较，差异无统计学意义（P>0.05）。结论相比传统的脑电图（EEG）监测，VEEG优势更加显著，能够显著提高癫痫样异常放电检出率和临床发作检出率，帮助临床医师确诊癫痫、明确分型，值得临床推广应用。
关键词：长程视频脑电监测；癫痫；时相；异常放电
[Abstract] Objective To analyze the clinicace of long term video EEG monitoring（VEEG）in the diagnosis of epilepsy，and to evaluate its clinical value. The object of this research method is from November 2013 to December 2015 in our hospital 174 cases，video EEG monitoring in patients，retrospective analysis，and the results were 2，6，EEG 12，24 h were analyzed to understand the clinical seizures and epileptic discharge associated abnormal. Results in 174 of the patients，115 cases of clinical seizures were observed，105 cases were diagnosed epilepsy，56 cases could not clearly diagnose whether they belonged to epilepsy，and the other 13 cases were diagnosed as non epileptic patients. Of the 59 patients without clinical seizures，39 cases had abnormal interictal discharges，and the epilepsy could not be ruled out. The remaining 20 cases had no abnormal discharge，and could not be diagnosed as epilepsy. Of the 174 patients，144 had abnormal discharge，12 of which were in the waking phase，50 in the sleep stage，and 82 in the awake and sleep periods. In addition，105 patients were diagnosed with abnormal EEG changes before the attack. At the same time，the clinical attack rates of 2 h phase and 6 h phase were compared according to the monitoring phase，the difference was statistically significant（P<0.05）. There were significant differences in the clinical attack rate between the 6 h phase and 12 h phase（P<0.05）. There was no significant difference in the clinical attack rate between the 6 h phase and 24 h phase（P>0.05）. There was no significant difference in the rate of abnormal discharge between the four phases（P>0.05）. Conclusion compared with the traditional EEG（EEG）monitoring，VEEG more significant advantages，can significantly improve the detection rate of epileptiform discharge and abnormal clinical seizure detection rate，help the clinician diagnosis of epilepsy and clear classification，it is worthy of clinical application.