100例癫痫患者脑电图与磁共振分析

目的:观察脑电图和头颅MRI在确诊癫痫及其病因诊治方面的应用,探讨痫性放电与结构异常之间的关系。方法:选100例癫痫患者,均作REEG、AEEG、头颅CT和MRI检查。比较四种检查方法的阳性率和异常病灶的分布。应用卡方检验,比较痫性放电与结构异常之间的关系。结果;REEG痫性放电35例(35%),AEEG76例(76%),比REEG多提供了41%的异常信息。CT发现颅内异常25例(25%),MRI发现异常58例(58%)。在EEG单侧局灶放电的53例中,MRI异常42例,18例双侧半球放电中,MRI异常5例,经x2检验,局灶痫性放电者MRI异常率显著高于双侧半球痫性放电者(P<0.01);MRI正常的42例患者中EEG痫性放电26例,异常率为61.9%,MRI发现结构异常的58例患者中,EEG异常放电50例,异常率为86.2%,经x2检验发现MRI结构异常患者,痫性放电出现率高(P<0.01)。结沦:AEEG是确诊癫痫、指导治疗的有利依据;MRI可作为癫痫患者病因诊断的首选影像检查。痫性放电与结构异常有一定关系。     

动态脑电图对癫痫诊断的临床意义

癫痫作为一种发作性疾病,脑电图是不可缺少的常规检查方法,24小时动态脑电图(AEEG)因其观察时间长,故对癫痫诊断及鉴别诊断均有较大价值,现将我院2002～2003年以来65例拟诊和怀疑癫痫患儿的AEEG分析如下:     

棘波自动检测在颞叶癫痫患者长程脑电图中应用价值的初步研究

目的 探究Persyst自动检测技术在成人颞叶癫痫棘波自动检测中的应用价值。方法 连续选定苏州大学附属第一医院癫痫单元2019年1月1日—2019年12月31日期间脑电图数据库中符合纳排标准的患者脑电图记录,由两名高年资、由中国抗癫痫协会认证脑电图技术专家阅读和标记长程脑电图中的发作间期癫痫样放电,将两名专家一致的结果作为棘波判定的“金标准”,与Persyst11、13、14三个版本在0.5～0.9之间不同感知值下的棘波自动检测结果进行回顾性研究,计算敏感性、假阳性率、减少的工作量。结果 共纳入7例颞叶癫痫患者,每例记录时间为24～25 h,总记录时间为169 h。两名阅图者总体一致率为43.09%。自动检测棘波敏感性最高出现于感知值0.5时,分别为62.26%、77.0%和67.28%,假阳性率最低出现于感知值为0.9时,分别为0.37个/min、0.85个/min、0.46个/min。借助自动分析最多可减少14.59%～37.05%的阅图量。结论 Persyst自动检测棘波的敏感性较高,假阳性也较高,不同版本间存在区别,与人工阅图进一步结合,减少一定工作量。通过合理的调整Perce...     

癫痫患者痫样放电时间分布与临床

我院从１９９６年１０月至１９９８年３月采用北京明思公司研制激光动态脑电图系统,对临床诊断为癫痫的患者进行２４ｈ监测,共检出典型痫样放电（尖、棘、尖慢、棘慢综合波）患者２４８例,对痫样放电时间进行了统计学分析并应用于临床,现报告如下：资料与方法我们从１...     

33例抗生素相关性癫痫患者的临床特点分析

目的 明确抗生素与癫痫的相关性,为临床用药提供参考。方法 选取2011年12月至2020年12月华西第四医院与重庆医科大学附属第二医院痫性发作住院患者共617例,其中筛选出与抗生素相关的痫性发作患者共33例并纳入研究。从纳入患者的基础疾病、抗癫痫药物使用情况、住院期间使用的抗生素、痫性发作情况、处理及预后等方面进行统计学分析。结果 33例患者治疗期间服用较多的抗癫痫药物是丙戊酸(VPA),其次为左乙拉西坦(LEV)。住院期间使用的可能诱发痫性发作的抗生素中,青霉素、头孢类药物使用最多,其次为氟喹诺酮类药物。抗生素使用以静脉滴注者最多,口服者较少(仅5例)。纳入患者中茶碱类药物、非甾体类药物使用率也较高,均达到了18%,33例中癫痫大发作8例,局灶性发作14例,非痉挛性发作11例。患者自首次使用抗生素到第一次痫性发作间隔时间从10 min到7 d不等,其中1～24 h内发病的患者占所有病例的76%。结论 抗生素相关性癫痫多发生于抗生素使用后24 h内,氟喹诺酮类药物与痫性发作可能并非因果关系,而是多种因素综合导致了抗生素使用期间的痫性发作。     

A Clinic for Managing Epileptic Patients with Psychiatric Problems in a Provincial Catchment Area A Review of the First 50 Cases

• 1 There were 50 cases referred to a clinic for managing epileptic patients with psychiatric problems in the Mid-Sussex area in 3 years.
• 2 Many of those referred were disabled and included severe personality disorders, which was the most important disabling factor we found.
• 3 Four fifths of the total referred lived at home and needed social support, as their families carried the load.
• 4 Forty-four percent were unemployable for various reasons, personality factors being the most important. Only a small proportion could use sheltered workshops if available.
• 5 Only 2 cases were impaired for work due to fits.
• 6 A relatively small and static number of seriously disabled epileptics required special psychiatric care in the Mid-Sussex area.
• 7 In our opinion, the recommendations of the Cohen Report are helpful in pinpointing the issues, with particular reference to psychiatric problems associated with epilepsy, but the value of this clinic depends upon the referrals sent to it by other specialties especially by neurologists who see by far the largest number of cases of epilepsy in any area.

     

短暂性脑缺血发作97例临床分析

目的探讨短暂性脑缺血发作(TIA)的临床特征、影像学资料和治疗效果。方法回顾性分析2002年～2006年间临床诊断为TIA的97例患者．将其分为两组,即颈内动脉系统TIA组和椎基底动脉系统TIA组,分析其临床资料、影像学资料和治疗随访结果。结果本研究中TIA患者发病到就诊时间的几何均数为3．31 d,发作持续时间为12．32 min,发作持续时间是否超过1 h与能否复发或进展为卒中无显著关系;TIA患者的危险因素包括高血压、冠心痛、糖尿病和脑梗死病史;CT发现脑梗死灶的阳性率为29．4%～50%,MRI阳性率为100%;随访3个月发现,脑梗死发生率为4．5%:两组患者在发病到就诊时间、持续时间、危险因素、CT阳性率及脑梗死发生率等方面均无显著性差异。结论颈内动脉系统和椎基底动脉系统TIA存在共同的临床特征,多数TIA患者不能及时就诊,发作持续时间几何均数接近文献报道水平;发作持续时间是否超过1 h不影响3个月预后。     

Cases of video electroencephalogram: differential diagnosis in newborn infants

This study addresses a number of general considerations on epilepsies and epileptic syndromes that develop in the neonatal period. The chronological limits of this stage of maturation are set out and the pathophysiology of the convulsive phenomenon during that period are briefly analysed. Furthermore, the differences that exist as a result of the incipient level of maturity of the newborn infant's central nervous system with regard to other ages, and obviously adults, are highlighted. Likewise, reference is made to the percentage values of this pathology, which even vary depending on the gestational age. The clinical expression has a personality that is very different from the other stages of maturation in children, with four predominant manifestations: subtle, tonic, clonic and myoclonic seizures, which have been universally accepted since they were first reported by Volpe. Epilepsies in the newborn infant are not sufficiently well differentiated in the different classifications of epilepsies and epileptic syndromes that have appeared in recent years, although they could well be, since they display enough significance and individuality for that to be so. Three clinical cases are reported, with the aid of video electroencephalographic findings, to illustrate some of the possible neonatal epileptic manifestations.     

脑电图在脑梗死中的应用分析

目的 探讨 EEG 对脑梗死的诊断价值.方法 回顾性分析92 例急性脑梗死患者的EEG 资料,并与头颅 CT 作对比研究.结果 24 h 内急性脑梗死患者EEG异常率 90.21 %,而头颅 CT 异常率52.17%,两者比较差异有统计学意义.结论 对脑梗死早期EEG检查较CT更为重要,且EEG对脑梗死患者判断病情及预...     

Experience with the International League Against Epilepsy Proposals for Classification of Epileptic Seizures and the Epilepsies and Epileptic Syndromes in a Pediatric Outpatient Epilepsy Clinic

The International League Against Epilepsy proposals for classification of epileptic seizures (1981) and of the epilepsies and epileptic syndromes (1985) have been used in daily practice in a pediatric epilepsy clinic in Bogota, Colombia. Most patients can be classified by these schemes, and the classifications are useful in everyday diagnosis and management. However, there are some drawbacks and difficulties with the classifications. Some syndromes are unnecessarily separated as different entities, artificially contributing to the complexity of the Classification.