312例动态脑电图与常规脑电图对比分析

方法:312例患者分成3组:A组症状性癫(疒间)28例,B组原发性癫(疒间)234例,C组发作性症状50例。作AEEG与REEG对比分析。结果:A组(疒间)样放电,局灶性异常率AEEG分别为67.68%,78.57%高于REEG28.57%,39.29%。B组(疒间)样放电,局灶异常AEEG分别为67.52%,64.96%也明显高于REEG29.06%,35.47%。C组局灶异常AEEG36%高于REEG16%。在AEEG监测过程中,10例有临床发作。B组158例AEEG有(疒间)样放电,122例(65.59%)出现于睡眠中,其中114例次(93.44%)在NREM Ⅰ,Ⅱ期。结论:AEEG能提高癫(疒间)确诊率。     

240例睡眠/清醒不同发作时间癫痫患者24小时动态脑电图分析

目的:了解睡眠/清醒不同发作时间癫痫患者24小时动态脑电图特点。方法:回顾性分析240例癫痫患者的24小时动态脑电图资料。结果:仅于睡眠中发作的癫痫患者AEEG上仅在睡眠中放电的比例高于清醒期和睡眠/ 清醒均发作患者,额叶癫痫患者于睡眠中发作者以及AEEG上单纯夜间放电者均明显多于颞叶癫痫患者,差异具有显著性(P<0.01)。结论:额叶癫痫患者及临床上仅于睡眠中发作患者睡眠中放电明显高于其他癫痫患者,对此类睡眠中高发人群进行AEEG检查有助于提高诊断率。     

快速眼动期动态脑电图对儿童癫诊断的价值

目的　探讨快速眼动期(REM)动态脑电图(AEEG)对儿童癫疒间(EP)诊断的价值。方法　观察100例患儿(拟诊EP73例,其他发作性疾病27例)的AEEG,并分析比较清醒期、非快速眼动期(NREM)、REM期疒间样放电检出率及分布情况。结果　AEEG清醒期EP波的检出率明显高于常规脑电图(P<0. 001);而REM、NREM期EP波检出率显著高于清醒期(均P<0 .01 ), REM期与NREM期比较差异无显著性(P>0. 05);清醒及NREM期均有EP波的患儿REM期出现EP波可能性大;REM期EP波出现最多的部位为颞区、颞中央区,明显高于其他各脑区EP波的出现率。结论　儿童REM期AEEG的EP波的检出率高,对EP的诊断、病灶定位有重要作用。     

快速眼动期动态脑电图对儿童癫(疒间)诊断的价值

目的探讨快速眼动期(REM)动态脑电图(AEEG)对儿童癫疒间(EP)诊断的价值.方法观察100例患儿(拟诊EP 73例,其他发作性疾病27例)的AEEG,并分析比较清醒期、非快速眼动期(NREM)、REM期疒间样放电检出率及分布情况.结果 AEEG清醒期EP波的检出率明显高于常规脑电图(P<0.001);而REM、NREM期EP波检出率显著高于清醒期(均P<0.01), REM期与NREM期比较差异无显著性(P>0.05);清醒及NREM期均有EP波的患儿REM期出现EP波可能性大;REM期EP波出现最多的部位为颞区、颞中央区,明显高于其他各脑区EP波的出现率.结论儿童REM期AEEG的EP波的检出率高,对EP的诊断、病灶定位有重要作用.     

快速眼动期动态脑电图对儿童癫痫诊断的价值

目的探讨快速眼动期(REM)动态脑电图(AEEG)对儿童癫疒间(EP)诊断的价值.方法观察100例患儿(拟诊EP 73例,其他发作性疾病27例)的AEEG,并分析比较清醒期、非快速眼动期(NREM)、REM期疒间样放电检出率及分布情况.结果 AEEG清醒期EP波的检出率明显高于常规脑电图(P<0.001);而REM、NREM期EP波检出率显著高于清醒期(均P<0.01), REM期与NREM期比较差异无显著性(P>0.05);清醒及NREM期均有EP波的患儿REM期出现EP波可能性大;REM期EP波出现最多的部位为颞区、颞中央区,明显高于其他各脑区EP波的出现率.结论儿童REM期AEEG的EP波的检出率高,对EP的诊断、病灶定位有重要作用.     

动态脑电图在癫痫诊断及鉴别诊断中的价值

目的研究24 h动态脑电图(AEEG)在癫(疒间)的诊断及鉴别诊断中的价值.方法对761例临床拟诊为癫(疒间)及1327例可疑癫(疒间)患者的AEEG资料进行回顾性分析.结果两组AEEG与常规脑电图检查(疒间)样放电检出率比较差异有极显著性(均P＜0.005).230例患者通过AEEG监测证实为癫(疒间)发作.93例患者AEEG监测后发作类型得到了修正.结论 AEEG有助于癫(疒间)的诊断及鉴别诊断.     

动态脑电图在癫(疒间)诊断及鉴别诊断中的价值

目的研究24 h动态脑电图(AEEG)在癫(疒间)的诊断及鉴别诊断中的价值.方法对761例临床拟诊为癫(疒间)及1327例可疑癫(疒间)患者的AEEG资料进行回顾性分析.结果两组AEEG与常规脑电图检查(疒间)样放电检出率比较差异有极显著性(均P＜0.005).230例患者通过AEEG监测证实为癫(疒间)发作.93例患者AEEG监测后发作类型得到了修正.结论 AEEG有助于癫(疒间)的诊断及鉴别诊断.     

长程脑电图在癫(癇)诊断与鉴别诊断中的价值

目的探讨长程脑电图(EEG)在癫疒间诊断与鉴别诊断中的价值。方法对265例癫疒间患者(癫疒间组)和206例非癫疒间患者(非癫疒间组)进行长程EEG记录,并进行分析。结果癫疒间组清醒EEG异常率为54.72%,睡眠EEG异常率为89.81%,两者差异有极显著性(P<0.001);非癫疒间组清醒EEG异常率为7.28%,睡眠EEG异常率为10.68%,两者差异无显著性(P>0.05)。癫疒间组患者睡眠时额叶和颞叶的癫疒间性放电阳性率最高,分别为20.38%和24.15%,与清醒状态阳性率(11.32%和11.70%)相比差异有极显著性(均P<0.01)。结论长程EEG在癫疒间的诊断和鉴别诊断中有重要意义,特别是多个周期的睡眠诱导可明显提高癫疒间性放电的阳性率,并对致癫疒间灶的定位提供重要参考。     

伽玛刀治疗难治性癫疒间的动态脑电图随访研究

目的探讨难治性癫疒间γ-刀治疗后动态脑电图(AEEG)随访意义及异常情况。方法采用上海群天PI400A-B型AEEG仪,对2003年至2010年γ-刀治疗后的85例难治性癫疒间患者,进行AEEG随访监测。结果 AEEG正常27例(31.8%),异常58例(68.2%,其中疒间样波20例(34.5%),非特异性异常38例(65.5%)。Wieser疗效分级Ⅰ～Ⅱ级组疒间样波发放率(6.1%)明显低于Ⅲ～Ⅳ组(23.7%)和Ⅴ～Ⅵ级组(64.3%)(P<0.05～0.01)。结论γ-刀治疗难治性癫疒间效果良好者(Ⅰ～Ⅳ级)的AEEG异常以非特异性高幅阵发性θ、δ波为主。癫疒间疗效愈好的脑电图异常率和疒间样波发放率愈低。AEEG有利于评价γ-刀治疗癫疒间的效果和指导γ-刀治疗后的临床用药。     

额叶癫痫患者动态脑电图与过度换气脑电图放电规律探讨

目的 了解动态脑电图(AEEG)中睡眠中放电与过度换气脑电图(EEG)的放电规律.方法 评估65例额叶癫痫患者AEEG与过度换气EEG的痫性放电特点.结果 过度换气中发现痫性放电率明显低于AEEG中浅睡眠期(非快速眼动相1,2期)EEG,差异具有统计学意义(P＜0.05);而与AEEG中清醒期和深睡眠期(非快速眼动相3,4期)比较,差异无统计学意义(P＞0.05).结论 额叶癫痫患者AEEG中浅睡眠期痫性放电率明显高于过度换气EEG,对额叶癫痫患者进行睡眠AEEG检测,有助于提高痫性放电的诊断率.     

24小时动态脑电图监测Tourette综合征癫痫样放电

目的：探讨Ｔｏｕｒｅｔｔｅ综合征（ＴＳ）癫痫样脑波的是临床意义。方法：利用动态脑电图仪对８６例ＴＳ患儿作２４小时监测。结果：８６例ＴＳ患儿中有１３例（１５．１％）监测到ＥＥＧ癫痫样放电。其中５例（６％）合并癫痫,８例（９．３％）无癫痫发作。结论：ＴＳ的癫痫样波一部分与癫痫有关,另一部分意义未明,可能遗传有关。     

动态脑电图在癫诊断中的应用价值

目的 探讨动态脑电图在癫癎诊断中的应用价值.方法 记录169例临床拟诊癫癎患者的24h脑电活动,与常规脑电图检查进行对比.结果 动态脑电图癎样放电率(62.72%)及总异常率(86.98%)与常规脑电图比较差异有统计学意义(P均<0.01).睡眠期癎样放电率明显高于清醒期.结论 24h动态脑电图可提高癎样放电的检出率,对癫癎的诊断有重要应用价值.     

录像脑电图监测对发作性疾病的诊断价值

目的研究录像脑电图（VEEG）在癫痫的诊断、鉴别诊断和临床发作分型中的价值,探讨癫痫患者自然睡眠时相与样放电之间的关系。方法使用录像脑电图对93例发作性疾病患者进行长程脑电监测,记录清醒和睡眠时的脑电图,并作诱发试验,明确发作性质,确定癫痫的临床发作类型,并分析发作间期癫痫样放电的睡眠-觉醒时相分布。结果93例发作性疾病患者中有临床发作者51例,样放电者72例,结合病史、临床表现和EEG结果而诊断为癫痫71例,其中69例患者确定了临床发作类型,20例修正了临床发作类型;71例确诊为癫痫患者中有完整睡眠-觉醒周期者65例,觉醒期有样放电者49例,睡眠期有样放电者61例,其中NREMⅠ-Ⅱ期52例（85.2%）,NREMⅠ-Ⅳ期3例（4.9%）,NREWⅢ-Ⅳ期6例（9.9%）,REM期未见。结论VEEG检测有利于癫痫的诊断和确定临床发作分型,睡眠监测有助于样波的检出,睡眠期样放电主要出现于NREMⅠ-Ⅱ期。     

动态脑电图对癫痫诊断和鉴别诊断的探讨

目的：了解动态脑电图对癫痫诊断和鉴别诊断的意义。方法：用MB8000型8导激光动态脑电图记录仪对145例诊断为癫痫,可疑癫痫病人进行24h动态脑电图检查。结果：总异常率为524％,癫痫组异常62．4％,癫痫样放电出现率58．1％。可疑癫痫组异常34．6％,痫样放电出现率25.0%,两级之间有非常显著性差异（P＜0.001）。癫痫组与可疑癫痫组临床发作中所描记到的痫样放电出现率亦有非常显著性差异（P＜0.001）。痫样放电时间以睡眠期为主,占83、3%。结论：本文着重分析讨论了动态脑电图睡眠期的意义及对伪迹鉴别的体会,24h脑电图对癫痫的诊断和鉴别诊断明显优于常规脑电图,有着重要的临床意义。     

Sleep Microstructure and EEG Epileptiform Activity in Patients with Juvenile Myoclonic Epilepsy

Clinical and EEG manifestations of juvenile myoclonic epilepsy (JME) occur in a strict relationship to the sleep-wake cycle, particularly to transition phases (awakening, falling asleep, afternoon relaxation after work). JME manifestations are deactivated during sleep. Because arousal fluctuations during NREM sleep may be controlled by the same neurophysiologic mechanisms regulating awakening, we studied the relationship between the cyclic alternating pattern (CAP) and JME manifestations. All-night polysomnographic recordings of 10 JME patients were analyzed for variations of epileptiform EEG abnormalities in relation to sleep stages and to different microstructural variables (NCAP, CAP, phases A and B). CAP rates (ratio between total CAP duration and total NREM sleep duration) were also calculated. Average CAP rate was 46.70%, significantly higher than that (23%) of an age-matched control group. Macrostructural analysis showed only a trend toward a slight predominance of EEG epileptiform activity during slow wave sleep but no significant correlation between spiking rates and sleep stages. Microstructural analysis confirmed the CAP modulation of EEG epileptiform activity, with maximum appearance of epileptiform abnormalities during phase A CAP (normalized spiking rate = 4.00 +/- 0.98) and strong inhibition during phase B (0.06 +/- 00.6). Intermediate values were noted during NCAP (0.54 +/- 0.27). No correlation was noted between spiking rates during NREM sleep and CAP rates, possibly indicating that in JME patients the increased CAP rate may be partially independent of epileptiform EEG activity. Our data suggest that in JME patients CAP may be a neurophysiologic oscillator organizing expression of the epileptiform discharges independent of the tendency of the individual patient to produce epileptiform EEG discharges.     

剥夺睡眠脑电图在癫诊断中的应用

目的 分析睡眠脑电图(EEG)在癫诊断中的价值及适应证.方法 对200例癫病人的睡眠及清醒脑电图进行研究.结果 脑电图有异常爆发活动(PA)者80例,PA只在睡眠中出现者30例,样放电检出率由清醒的25%提高到睡眠的40%.结论 睡眠脑电图对提高样放电的检出率和进一步明确癫发作类型有重要意义.     

癫痫的多导睡眠研究

目的:了解癫痫放电在自然睡眠各期及觉醒状态下分布情况,为癫痫的诊断与优化治疗提供客观参考依据。方法:筛选40例全身性强直—阵挛发作尚未用AEDs治疗的癫痫患者,用英国OXFORD Medilog 9200型动态脑电监测仪同时进行多导睡眠记录和动态脑电图记录。结果:40例中有33人记录到典型癫痫波(82.5%),30人记录到慢波阵发(75%),11人记录到α高尖阵发(27.5%)。结论:本研究提示典型癫痫放电和慢波发放主要在W和S_(1,2)较多,其次是在REM,在S_(3,4)相对较少,α高尖阵发主要是在W和S_(1,2),这说明痫样放电在觉醒和睡眠时均有相当的放电时间和次数。本研究还提示通过动态脑电图检测或结合多导睡眠图可详细准确了解痫样放电的24小时分布状况,对指导调整AEDs的用量和服用时间,实现癫痫优化治疗有重要意义。     

Supervision of ambulatory cassette EEG screening: a strategy based on the temporal distribution of epileptiform abnormalities

The interposition of screening personnel in the analysis of extended cassette EEG recordings requires a method for supervision by the responsible electroencephalographer. To this end, analysis was undertaken of the temporal distribution of epileptiform abnormalities and seizures on cassette EEG in 40 epilepsy unit inpatients for whom these abnormalities were confirmed by simultaneous cable telemetry. Epileptiform abnormalities were noted in the hour following sleep onset in 38 patients (92%). Seizures occurred primarily in wakefulness. One hundred cassette EEG tapes obtained for clinical purposes and previously found to contain evidence of epilepsy were then subjected to an abbreviated review. Eighty-seven contained epileptiform abnormalities in the first hour of sleep, and 7 additional tapes contained only EEG seizure activity coincident with reported clinical events. Considering that fewer than 20% of cassette recordings obtained in unrestricted clinical use are likely to harbor epileptiform abnormalities or seizures, correct identification of about 99% of tapes as normal or abnormal can be anticipated with an abbreviated review consisting of analysis of the first hour of sleep; and analysis of reported clinical events if no abnormalities are noted in the first hour of sleep. Such a review is sufficiently accurate to serve as a supervisory analysis of cassette EEG tapes that have been previously screened and reported to lack evidence of epilepsy.