自然睡眠脑电图对癫痫的诊断价值

自然睡眠是癫痫脑电图的有效诱发方法之一，我院近几年对120例临床拟诊为癫痫的患者行常规脑电图和自然睡眠脑电图检查，以分析其对癫痫的诊断价值，现报告如下。     

自然夜间睡眠脑电图对颞叶癫痫的诊断价值

目的：探讨自然夜间睡眠脑电图对颞叶癫痫的诊断价值。方法;采用国际10－20系统对20例患连续10h EEG描记。结果：颞叶区出现3－3.5%痫样波14例。结论：自然睡眠脑电图对癫痫的诊断和分型具有重要意义。     

自然睡眠脑电图对癫癎的诊断价值

自然睡眠是癫癎脑电图的有效诱发方法之一,我院近几年对120例临床拟诊为癫癎的患者行常规脑电图和自然睡眠脑电图检查,以分析其对癫癎的诊断价值,现报告如下.     

剥夺睡眠脑电图监测对癫痫诊断的意义

近年来,长程脑电图监测技术的发展,对提高癫(疒间)脑电图的异常率及对癫(疒间)分型有很大的帮助.我院从1998年8月至2002年8月共对47例临床有癫(疒间)样发作的患儿进行了清醒时的脑电图监测与剥夺睡眠后睡眠时的脑电图的监测.现将结果报告如下.     

212例癫痫发作患者的剥夺睡眠一自然睡眠脑电图分析

剥夺睡眠一自然睡眠诱发试验,有助于提高癫痫患者的脑电图阳性率,对那些只在夜间发作及常规脑电图中看不到异常放电的患者尤为适用.为此,自1990年以来,我们对212例临床初步诊断为癫痫的患者做常规脑电图及剥夺睡眠一自然睡眠诱发试验,以分析其对癫痫的诊断价值.     

剥夺睡眠脑电图在小儿癫痫中的诊断价值

目的探讨剥夺睡眠脑电图和常规脑电图在小儿癫痫诊断中的临床意义.方法对92例临床初步诊断癫痫的患儿进行常规脑电图检查和剥夺睡眠诱发脑电图检查.比较二种方法的异常率和痫样放电检出率.结果:常规脑电图异常率(69/92)75%,剥夺睡眠脑电图异常率(79/92)86%,两者比较无显著差异(x2=3.45,P＞0.05).在痫样放电检出率方面,常规脑电图检出率(38/92)41.3%,剥夺睡眠脑电图检出率(70/92)76.09%,两者比较有显著差异(x2=22.96,P＜0.01).在临床发作类型方面,应用剥夺睡眠脑电图使复杂部分性发作、失神发作痫性检出率达100%.结论剥夺睡眠脑电图在小儿癫痫的诊断中,优于常规脑电图,可以明显提高精神运动性发作,睡眠相关性癫痫的痫样放电检出率,是目前公认的具有重要价值,最简便易行的检测手段之一.     

癫痫的睡眠动态脑电图临床应用价值

目的:探讨睡眠期动态脑电图(AEEG)在癫痫诊断中的作用。方法:利用 AEEG对836例癫痫患者自然睡眠期脑电波变化进行监测、分析。结果:正常106例 (12.7％),非特异性异常61例(7.3％),痫样波发放669例(80.0％),总异常730例 (87.3％)。痫样波出现于清醒期84例(12.5％),睡眠期408例(61.0％)。睡眠期明显高 于清醒期P<0.01。而睡眠期(NREM Ⅰ-Ⅱ期)占多数473／585例(80.7％)。结论:癫 痫和睡眠密切相关,通过自然和药物诱发睡眠,有助于提高癫痫脑电图阳性率,尤其是自然 睡眠AEEG对癫痫的定位诊断和分类更具有重要意义。对临床诊断困难的非典型发作及各种 不常见类型癫痫的作用更加突出,甚至起着决定性的作用。     

日间睡眠脑电图在癫痫诊断中的应用

目的：探讨睡眠脑电图（ＥＥＧ）在癫痫诊断中的价值及适应症。方法：过去１０年间５２２例患有癫痫及各种发作性疾患病人的睡眠及清醒ＥＥＧ进行研究。结果：ＥＥＧ有异常爆发活动（ＰＡ）者２１７例，ＰＡ只在睡眠中出现者９６例，痫样放电的检出率由清醒的２３２％提高到４１６％。１５例病人通过发作间期或发作期的睡眠ＥＥＧ显示的ＰＡ，进一步明确癫痫发作类型。在９７例有中央—颞棘波的儿童良性部分性癫痫中，５０例（５１６％）的局灶ＰＡ只发生在睡眠期。４例长期抗癫痫药治疗后，临床发作停止，清醒ＥＥＧ恢复正常，但睡眠ＥＥＧ仍有爆发活动，病人自行停药后，２例癫痫发作复发。结论：睡眠ＥＥＧ对提高痫样波的检出率和进一步明确癫痫发作类型有重要意义     

110例癫痫患者24hAEEG临床应用报告

目的对１１０例癫痫患者的２４ｈ动态脑电图（ＡＥＥＧ）的应用价值进行了初步探讨。方法使用英国的ＯｘｆｏｒｄＭｅｄｉｌｏｇ９２００型８导磁带记录仪进行２４ｈ描记后作离线回放分析，并与普通ＥＥＧ相比较。结果１１０例中ＡＥＥＧ异常６２例（５６．４％），９８例中ＥＥＧ发现异常３２例（３２．７％）。ＥＥＧ正常而ＡＥＥＧ异常３０例，ＥＥＧ异常而ＡＥＥＧ正常９例。结论ＡＥＥＧ明显优于ＥＥＧ，但有时ＡＥＥＧ也不能捕获到间歇期的发作波。分析ＡＥＥＧ记录必需注意将睡眠Ⅰ、Ⅱ期出现的高幅顶尖波、纺锤波与痫样波区分开来，以免导致错误诊断。ＡＥＥＧ对颞叶和额叶底面的致痫灶反应较差，需补做特殊电极的ＥＥＧ，如蝶骨电极。     

癫痫患者的脑电图与CT对比研究

目的：探索ＥＥＧ和ＣＴ在癫痫的诊断、分型和病因方面的意义。方法：对１３７９例癫痫进行ＥＥＧ常规描记和脑ＣＴ扫描。结果：１３７９例中原发性癫痫９８５例（７１４３％），继发性癫痫３９４例（２８５７％）。ＣＴ异常率４６１９％；ＥＥＧ异常率７４２６％，痫波检出率２３４７％。ＥＥＧ以局灶性或弥漫性慢波增多为主。ＥＥＧ和ＣＴ的符合率８０９５％。结论：ＥＥＧ对癫痫的分型和原发性癫痫的检出有重要价值，而ＣＴ则是查找继发性癫痫病因的有效方法     

468例癫癎患者睡眠期癎样放电与睡眠结构变化分析

目的：观察癫 患者的睡眠时相与 样放电的关系,并初步探讨癫 异常脑波活动对睡眠的影响。方法：对４６８例癫　患者进行２４小时动态脑电图（ＡＥＥＧ）监测,观察发作间期清醒与睡眠脑电图　样放电的发作频率,分析５８例癫　患者及对照组睡眠脑电图中睡眠时程、觉醒次数、睡眠纺锤波的变化。结果：４６８例患者中出现　样放电３６２例,睡眠期　样放电检出率８８％,觉醒期检出率５８％。样放电主要出现于ＮＲＥＭ睡眠Ⅰ－Ⅱ期。与对照组比较,癫　组ＮＲＥＭ　Ⅰ－Ⅱ睡眠期延长,ＮＲＥＭ Ⅲ－Ⅳ期缩短;觉醒次数增加,觉醒次数与　样放电频率呈正相关;并有睡眠纺锤波减少及不对称。结论：癫　患者的　样放电主要出现于ＮＲＥＭ睡眠Ⅰ－Ⅱ期,癫　活动对睡眠有一定影响,癫　患者睡眠质量下降。     

Mobile EEG in epilepsy

The sensitivity of routine EEG recordings for interictal epileptiform discharges in epilepsy is limited. In some patients, inpatient video-EEG may be performed to increase the likelihood of finding abnormalities. Although many agree that home EEG recordings may provide a cost-effective alternative to these recordings, their use is still not introduced everywhere. We surveyed Dutch neurologists and patients and evaluated a novel mobile EEG device (Mobita, TMSi). Key specifications were compared with three other current mobile EEG devices. We shortly discuss algorithms to assist in the review process. Thirty percent (33 out of 109) of Dutch neurologists reported that home EEG recordings are used in their hospital. The majority of neurologists think that mobile EEG can have additional value in investigation of unclear paroxysms, but not in the initial diagnosis after a first seizure. Poor electrode contacts and signal quality, limited recording time and absence of software for reliable and effective assistance in the interpretation of EEGs have been important constraints for usage, but in recent devices discussed here, many of these problems have been solved. The majority of our patients were satisfied with the home EEG procedure and did not think that our EEG device was uncomfortable to wear, but they did feel uneasy wearing it in public.     

EEG sleep, depression, and aging

—To date little attention has been paid to the posssible age-dependent relationships of EEG sleep measures in depression or to the implications of such relationships for diagnostic sensitivity and specificity. In a study of 108 patients with major depressive disorders (67 inpatients, 41 outpatients), age was shown to be a very powerful determinant of electroencephalographic (EEG) sleep patterns. Thus, among other sleep variables, sleep efficiency, delta sleep percent, and REM latency all showed significant linear declines with increasing age. Similar trends were seen in both inpatients and outpatients. Some variables were without age trends (age-stable), including sleep latency, REM sleep percent, and REM activity. These findings confirm those of an earlier report from our laboratory [45] and suggest that age-corrected sleep variables can be developed for clinical diagnostic application. Thus, using normative data from Gillin et al. [19] for comparison, a sensitivity level of 65% for age-corrected REM latency was demonstrated, together with a specificity of 95% and a diagnostic confidence of 92%. Data from a pilot study comparing EEG sleep measures in depression and dementia are also presented; these data suggest the potential utility of EEG sleep measures in the differential diagnosis of these two disorders, especially in patients with mixed symptoms. Additional areas for further research are reviewed with enumeration of specific testable hypotheses.     

EEG sleep, depression, and aging

—To date little attention has been paid to the posssible age-dependent relationships of EEG sleep measures in depression or to the implications of such relationships for diagnostic sensitivity and specificity. In a study of 108 patients with major depressive disorders (67 inpatients, 41 outpatients), age was shown to be a very powerful determinant of electroencephalographic (EEG) sleep patterns. Thus, among other sleep variables, sleep efficiency, delta sleep percent, and REM latency all showed significant linear declines with increasing age. Similar trends were seen in both inpatients and outpatients. Some variables were without age trends (age-stable), including sleep latency, REM sleep percent, and REM activity. These findings confirm those of an earlier report from our laboratory [45] and suggest that age-corrected sleep variables can be developed for clinical diagnostic application. Thus, using normative data from Gillin et al. [19] for comparison, a sensitivity level of 65% for age-corrected REM latency was demonstrated, together with a specificity of 95% and a diagnostic confidence of 92%. Data from a pilot study comparing EEG sleep measures in depression and dementia are also presented; these data suggest the potential utility of EEG sleep measures in the differential diagnosis of these two disorders, especially in patients with mixed symptoms. Additional areas for further research are reviewed with enumeration of specific testable hypotheses.     

颞叶癫痫病人睡眠EEG放电规律的探讨

目的：探讨颞叶癫痫患者昼与夜的脑电图痫样放电特点。方法：对２０例颞叶癫痫患者及同年龄、性别的对照组进行连续４８ｈＥＥＧ监测，就其临床发作频率、睡眠各期痫样放电的频率、时程进行分析。结果：ＥＥＧ监测期间共发生１３次临床发作。其中清醒时６次，睡眠中７次；２０例病人均检出痫样放电，１８例出现于清醒和睡眠时，１例仅出现于睡眠中，另一例仅出现于清醒时。痫样放电出现于非眼快动睡眠相（ＮＲＥＭ）１期１６例，２期１８例，３期３例，４期４例，出现于眼快动睡眠相（ＲＥＭ）１２例。结论：颞叶癫痫的临床发作频率和痫样放电频率在清醒和睡眠时期基本相等。痫样放电在ＮＲＥＭ的１、２期和ＲＥＭ期明显增加     

EEG mapping for surgery of epilepsy

Summary This report describes the objectives, problems, and current techniques associated with using EEG maps in the management of surgery of epilepsy. The purpose of EEG mapping in epilepsy is to precisely identify and characterize epileptogenic zones of the brain. Such zones may be single or multiple, pointlike or diffuse, and may be near or distant from the recording electrodes. The resulting measured electric fields are used to obtain information which, when analyzed in light of all the complementary clinical information, can frequently help to localize and describe the epileptic foci with more precision.     

女性癫患者月经周期与临床发作和脑电图特点分析

&&女性癫患者月经周期与临床发作和脑电图特点分析@金一焕 @崔梅花 @李雄杰&&