小儿病毒性脑炎继发癫痫的EEG影像学及临床分析

目的探讨儿童病毒性脑炎继发癫痫(PEE)的脑电图(EEG)及影像学特点,进一步探讨其临床高危因素。方法以明确诊断的34例PEE患儿为观察组,选取同时期就诊的同年龄段病毒性脑炎未继发癫痫(no-PEE)患儿102例为对照组。收集患儿病毒性脑炎(VE)急性期临床资料,并进行随访。结果单因素分析得出2组病脑急性期痫性发作≥2次、癫痫持续状态(SE)、昏迷,EEG癫痫样放电、广泛或弥漫性慢波,影像学单纯皮层受损、皮层及皮层下受损、丘脑基底节受损差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,病毒性脑炎急性期痫性发作≥2次、SE、昏迷、EEG癫痫样放电、影像学皮层及皮层下同时受损差异有统计学意义(P<0.05),为PEE危险因素。2组患儿随访期间智力发育落后差异有统计学意义(P<0.001)。结论病毒性脑炎急性期EEG癫痫样放电、影像学皮层及皮层下同时受损、痫性发作≥2次、SE、昏迷为PEE危险因素。PEE患儿远期多有智力发育落后,应密切随访,及时干预治疗。

Electroencephalogram,MRI/CT and clinical analysis of postencephalitic epilepsy in children

Objective To describe the EEG and image characteristics of the Postencephalitic epilepsy(PEE)of children with viral encephalitis and to further verify the high risk factors.Methods Thirty-four cases children with of viral encephalitis secondary epilepsy were taken as the observation group.One hundred and two children of the same period,same age groups and no secondary epilepsy(no-PEE)after viral encephalitis were selected as control group.The clinical data of 136 children with acute viral encephalitis were collected and all the children were followed up.Results Univariate analysis show that seizures≥2 times,epileptic status(SE),coma,EEG epileptic discharge,extensive or diffuse slow activity,imaging simple cortical damage,cortical and subcortical damage,thalamus-basal ganglia damage,the difference between the two groups was statistically significant(P<0.05).Multiple factors Logistic regression analysis show that seizures≥2 times,SE,coma,epileptic discharge,cortical and subcortical damage were statistically significant(P<0.05),which was the PEE risk factors.Between the two groups,there was a significant difference in mental retardation during follow-up(P<0.001).Conclusion Epileptic discharge,simultaneous cortical and subcortical damage,recurrent epileptic seizures,SE,and severe disturbance of consciousness(coma)are the PEE risk factors.Children with PEE are often retarded in mental development in the long term,should be closely followed up,timely intervention.