急性病毒性脑炎所致精神障碍脑电图的诊断价值

目的研究脑电图对于急性病毒性脑炎所致精神障碍的辅助诊断价值。方法在入院3天内对临床拟诊为急性病毒性脑炎所致精神障碍的病人分别进行脑电图、头颅CT、磁共振(MRI)检查,其中有48例确诊为病毒性脑炎所致精神障碍,分析病人的头颅CT、磁共振(MRI)以及中度或重度异常脑电图的机率,并进行比较。正常或轻度异常脑电图在一周后进行复查。结果头颅CT的异常率为12．50%(6/48),头颅MRI异常率为33．33%(16/48),中度或重度异常脑电图的发生率为66．67%(16/ 48),采用配对X~2检验比较脑电图与两种影像学方法(头颅CT、MRI)有显著性差异(P＜0．005);脑电图16例轻度异常者一周后有4例转为中度或重度异常。结论脑电图对急性病毒性脑炎所致精神障碍有重要的辅助诊断意义,比头颅MR等影像学检查有更高的敏感性。另外,脑电图轻度异常不能排除急性病毒性脑炎所致精神障碍。     

散发性脑炎伴发精神障碍患者脑电图观察

对本组以精神症状为主的散发性脑炎的EEG进行观察,未发现特异性改变,均为弥散性慢波,EEG对以精神症状为主的散发性脑炎与功能性精神病的鉴别及治疗有积极意义。     

慢性酒精中毒性精神障碍患者脑电图分析

目的：探讨慢性酒精中毒的脑电力产改变。方法：对９６例慢性酒精中毒性精神障碍患者进行脑电图检查并加做各种活化诱发试验。结果：显示异常率为６４．５％,明显高于正常人群的１０％,差异非常显著（Ｐ〈０．０１）。脑电图主要异常可分为失筝型和慢波型及阗样放电。结论：提示慢性酒精中毒对脑功能的影响及其及组织的损害是弥温性的,可能与脑组织的变性、萎缩等有关。     

脑电图反应性对昏迷患者的预测价值分析

目的探讨脑电图反应性对昏迷患者的预测价值。方法筛选符合条件患者26例,生存者做3个月内跟踪调查,3个月内死亡者调查停止,动态EEG记录EEG反应性。根据Synek分级将EEG类型进行预后分类。结果记录EEG有反应生存者为90%。无反应性者死亡为70%。根据Synek分级预后不确定的患者中,EEG有反应性的生存率92%,无反应性的生存率为32%,单因素结果分析,预后没发现显著相关性。GCS评分、Synek分级及EEG反应性与预后有关(均P0.01)。EEG反应性对判定预后的敏感性80%,特异性81.3%。真阴性(TN):指标良好且预后良好者;假阴性(FN):指标良好而预后不良者;真阳性(TP):指标不良而预后不良者;假阳性(FP):指标不良而预后良好者。多因素Logistic回归结果分析以临床指标及Synek分级、EEG反应为自变量进行的Logistic回归分析提示:EEG反应性、GCS评分及Synek分级为影响预后的显著相关因素(均P0.01)。结论 EEG的反应性对昏迷患者的预后有很好的预测价值。     

嗜酒所致精神障碍与脑电图地形图研究

对嗜酒所致精神障碍患者40例脑电地形图（BEAM）进行检查,并与40例无脑部疾病、无酗酒史的正常人进行比较,结果,患者组脑电地形图异常率为25%,伴随脑电图（EEG）轻度异常率22.5%。为研究酒精中毒患者大脑损害程度提供了参考依据。     

抗NMDA受体脑炎所致精神障碍的诊断与鉴别诊断

抗NMDA 受体脑炎是一类中枢神经系统自身免疫性脑炎,症状复杂,临床表现以精神行 为异常、不自主运动、癫痫发作和意识障碍为特点。本文结合两个案例探讨抗NMDA 受体脑炎与功能 性疾病所致精神障碍区别,以及脑电图在其诊断中的作用及意义。     

司法鉴定为癫痫性精神障碍者的脑电图分析

目的 探讨经司法精神病鉴定为生精神病障碍者的脑电图（ＥＥＧ）改变特点,及与精神障碍表现、临床发作类型、案件类型的关系。方法 对５２例经司法精神病鉴定为癫痫性精神障碍患者的ＥＥＧ资料进行回顾性分析。结果 常规ＥＥＧ异常率为５８％。广泛异常２２例,其中轻度１１例,中度９例,重度２例;局灶性异常８例。智能障碍、人格改变并智能障碍异常率均较高,且大多为广泛异常。伤害罪、抢劫罪、纵火罪、杀人罪及被奸淫案异常     

Clinical significance of EEG abnormalities during photic stimulation in patients with photosensitive epilepsy

PURPOSE: The continued presence of EEG abnormalities in patients with a history of photosensitive seizures is used to signify the persistence of photosensitive epilepsy. The extent to which this approach places patients at risk of seizures is unclear, however. We describe those EEG abnormalities that may be tolerated with low risk of further seizures, and those that are indicative of poor seizure control. METHODS: Fifty patients with EEG evidence of persistent photosensitive epilepsy underwent photosensitivity testing with diffuse and patterned light; 58% of patients continued to experience seizures, and 42% were seizure free. The incidence of EEG abnormalities to diffuse and patterned intermittent photic stimulation (IPS) was analysed as a function of recent seizures. RESULTS: All patients showed EEG abnormalities to patterned IPS; there was no significant association between patterned IPS and poor seizure control. EEG abnormalities to diffuse IPS occurred in 58% of patients, and 76% of these patients had experienced a seizure within the previous year. These patients were more than twice as likely to be poorly controlled than those who showed abnormalities only to patterned IPS. These results were consistent for both medicated and unmedicated patients. CONCLUSIONS: EEG abnormalities to patterned IPS can be used to signify the persistence of photosensitive epilepsy, but abnormalities to diffuse IPS are more likely to indicate the patient is poorly controlled and at risk of further seizures.     

规范化脑电图检查对癫痫诊断的价值

目的　探讨一种包括睡眠诱发在内的常用诱发试验、检查时间为 1.5～ 2小时、选择性蝶骨电极描记的“规范化脑电图”对癫痫诊断的价值。方法　对 2 36例癫痫患者先后进行传统的常规脑电图和规范化脑电图检查 ,并分别在常规脑电图和规范化脑电图检查后进行初步诊断和再诊断。结果　规范化脑电图癫痫放电阳性率 (81.36 % )明显高于常规脑电图 (2 9.6 6 % ) ,P<0 .0 0 1;再诊断时癫痫的分型诊断率明显高于初诊时 ,P<0 .0 0 1。结论　“规范化脑电图”检查可明显提高癫痫放电的检出率 ,能满足绝大多数癫痫病人的分型诊断需要     

Clinical and EEG characteristics of benign rolandic epilepsy in Chinese patients

We retrospectively evaluated the clinical and electroencephalogram (EEG) characteristics of benign rolandic epilepsy (BRE) in Chinese children. Two hundred and seventy-six patients with BRE were enrolled in this study. All patients had their first seizure between the ages of 3 and 12 years. 39.5% (109 cases) of patients ceased to have further BRE seizures by the age of 6 years, 93.1% (257 cases) recovered by the age of 12 years and 96.7% (267 cases) recovered by the age of 18 years. Two hundred and twenty-seven patients suffered only simple partial seizures, whereas 49 patients suffered generalized seizures from onset of BRE. The EEG scans of 239 patients showed repetitive diphasic spikes or sharp waves with high amplitude, which were most dominant in the central or centrotemporal areas. The spikes were confined to one hemisphere in 180 patients and occurred bilaterally in 59 patients. Ninety-eight patients were treated with antiepileptic drugs (AEDs): carbamazepine (CBZ) or valproate (VPA). The study showed that, in Chinese children, BRE is remarkably characteristic in its clinical and EEG presentation. Although BRE is usually benign in terms of ease of control with AEDs and spontaneous seizure remission, for those patients with a high frequency of seizures, AEDs should be prescribed positively.     

300例癫痫及可疑癫痫患者AEEG分析

目的：对３００例癫痫及可疑癫痫患者的动态脑电图的应用价值进行了初步探讨。方法;使用北京明思公司ＳＷ－ＪＨ系列智能化脑电监护仪描记,并与常规脑电图比较。结果：３００例中ＥＥＧ异常５４例,ＡＥＥＧ异常１７８例ＡＥＥＧ痫样放电检出率明显高天ＥＥＧ。１４４例继发性癫痫患者中,ＥＥＧ异常８例,ＡＥＥＧ异常１０例,二者无显著性差异。     

Quantitative EEG asymmetry correlates with clinical severity in unilateral Sturge-Weber syndrome

PURPOSE: Sturge-Weber syndrome (SWS) is a neurocutaneous disorder with vascular malformations of the skin, brain, and eye. SWS results in ischemic brain injury, seizures, and neurologic deficits. We hypothesized that a decrease in quantitative EEG (qEEG) power, on the affected side, correlates with clinical severity in subjects with SWS. METHODS: Fourteen subjects had 16-channel scalp EEG recordings. Data were analyzed using fast Fourier transform and calculation of power asymmetry. Blinded investigators assigned scores for clinical neurological status and qualitative assessment of MRI and EEG asymmetry. RESULTS: The majority of subjects demonstrated lower total power on the affected side, usually involving all four frequency bands (delta, theta, alpha, and beta). qEEG asymmetry correlated strongly with neurologic clinical severity scores and MRI asymmetry scores. qEEG data generally agreed with the MRI evidence of regional brain involvement. In MRI-qEEG comparisons that did not agree, decreased power on qEEG in a brain region not affected on MRI was more likely to occur in subjects with more severe neurologic deficits. CONCLUSIONS: qEEG provides an objective measure of EEG asymmetry that correlates with clinical status and brain asymmetry seen on MRI. These findings support the conclusion that qEEG reflects the degree and extent of brain involvement and dysfunction in SWS. qEEG may potentially be a useful tool for early diagnosis and monitoring of disease progression in SWS. qEEG may prove useful, in severely affected individuals with SWS, for determining regions of brain dysfunction.     

睡眠性癫癎患者动态脑电图的研究

目的探讨睡眠性癫疒间患者的24h动态脑电图(AEEG)的表现及其诊断价值。方法对91例仅于睡眠中发作癫疒间的患者进行AEEG检查,并对检查结果进行分析。结果AEEG发现疒间性放电71例(78.0%),其中4例出现于清醒状态,41例出现于睡眠状态,26例清醒和睡眠时均有放电;在67例睡眠时有疒间性放电的患者中,34例仅出现在浅睡期,33例整个睡眠中均出现疒间性放电。清醒时有癫疒间波的患者癫疒间发作频率明显高于无异常放电患者和仅睡眠时有疒间性放电的患者(均P<0.05)。结论睡眠中癫疒间发作患者于睡眠中疒间性放电出现率明显高于白天清醒时。AEEG容易发现睡眠性癫疒间患者的发作期和发作间歇期以及自然睡眠状态下的疒间样波。     

The value of early postictal EEG in children with complex febrile seizures

PURPOSE: To assess the usefulness of an early postictal EEG in neurologically normal children with complex febrile seizures. METHODS: We conducted a retrospective chart review of all neurologically normal children who were hospitalized over a period of 2.5 years after complex febrile seizures, and had an EEG up to 1 week after the seizure. RESULTS: Thirty-three patients (mean age, 17.8 months) qualified for inclusion into the study. Twenty-four patients were qualified as complex cases based on one factor (prolonged in 9, repetitive in 13, and focal in 2). Nine other patients had two complex factors: in six patients, the seizures were long and repetitive; in two patients, the seizures were focal and repetitive; and in one patient, the seizures were long, focal, and repetitive. Thirteen (39%) patients experienced prior febrile seizures. All 33 patients had a normal postictal sleep EEG. Our results indicate with a 95% probability that the true rate of abnormalities in an early postictal EEG performed on otherwise normal children with complex febrile seizures is 8.6% or less. CONCLUSIONS: The yield of abnormalities of an early postictal EEG in this population is low and similar to the reported rate of abnormalities in children with simple febrile seizures. The routine practice of obtaining an early EEG in neurologically normal children with complex febrile seizures is not justified.     

Sleep EEG of patients with obsessive-compulsive disorder

Summary Twenty-two patients suffering from an obsessive and compulsive disorder (OCD) according to DSM-III-R were investigated by polysomnographic sleep EEG recordings under drug-free conditions and compared to age- and sex-matched healthy controls. Sleep efficiency was significantly lower and wake % SPT was significantly increased in the patient group compared to healthy subjects. Sleep architecture did not differ among the two samples. Especially REM sleep measures, in particular, REM latency did not differ among the groups. No positive correlation was found between sleep variables and rating inventories for obsession and compulsions (Y-BOCS), depression (Hamilton) and anxiety (CAS). A secondary depression did not influence sleep EEG variables. The results of this study contradict the assumption that OCD patients show REM sleep and slow wave sleep abnormalities similar to those shown by patients with primary depression.     

Nocturnal sleep EEG in patients with HIV infection

Summary Nocturnal sleep was studied in 14 human immunodeficiency virus (HIV)-positive patients without opportunistic infections of the central nervous system. Seven patients had no bodily complaints at the time of the investigation. Patients exhibited an impaired nocturnal sleep with longer sleep onset latency, reduced total sleep time, reduced sleep efficiency, and more time spent awake and in stage 1. Stage 2 sleep was significantly decreased; in 2 cases, sleep spindle density was extremely low. REM latency was reduced and correlated negatively with depressive symptomatology, while the percentages of REM and slow wave sleep were normal. No significant differences in sleep parameters were present among patients in different stages of the illness, or between patients with and without bodily complaints. Ventricular size and sulcal width on computed tomography scans correlated with sleep variables indicating reduced sleep quality, and with REM density. Decreased tryptophan plasma levels were associated with shorter and less efficient sleep, and with reduced stage 2 sleep. The findings demonstrate that sleep EEG investigations can be valuable for detecting and monitoring central nervous system affection in HIV-positive individuals.This study was presented in part at the 10th Congress of the European Sleep Research Society, Strasbourg, France, 20–25 May 1990     

The value of EEG in the investigation of postapoplectic epilepsy

During the 5 years 1979-1983 61 patients within the county of Frederiksberg developed postapoplectic seizures after the age of 60. Of these patients EEG was performed on 48. These EEG's were compared to the EEG's from 25 patients of the same age with epilepsy due to cerebral tumors 33 patients with acute stroke and 24 patients with stroke sequelae who had not experienced seizures. Slow wave activity and foci were seen more often among patients with acute stroke than among patients with postapoplectic seizures whereas paroxysmal activity occurred less often in patients with acute stroke than among patients with postapoplectic seizures patients with stroke sequelae and patients with seizures due to cerebral tumours. Patients with stroke sequelae with proven hemispheric localization had focal abnormalities more often than patients with postapoplectic seizures but apart from this EEG difference between patients with postapoplectic seizures and patients with stroke sequelae or seizures due to brain tumours were not found. In 12 of the patients with postapoplectic seizures and in 20 of the patients with stroke sequelae without seizures EEG at the time of the acute stroke was available. Differences between patients with and patients without seizures were not found neither at the time of the acute stroke nor at the time of readmission due to stroke sequelae or due to onset of seizures. It is concluded that a routine EEG is without value in the diagnosis of postapoplectic seizures in the elderly.