双侧同步节律性慢波在幕上肿瘤患者继发癫痫中的易感性研究

目的探讨脑电图中出现双侧同步节律性慢波(bilateral synchronous rhythmic slow wave)在幕上肿瘤患者继发癫痫中的易感性。方法回顾性分析我院自2008年1月至2010年7月255例幕上肿瘤患者的动态脑电图(active elec-troencephalogram,AEEG)结果,根据术前是否伴有癫痫发作,将病例分为A组(有癫痫发作),B组(无癫痫发作)。将脑电图中仅有双侧同步节律性慢波定义为变量a,以痫样放电为参照,对仅出现痫样放电定义为变量b,同时具有双侧同步节律性慢波和痫样放电定义为变量a+b。分析三变量在2组间的差异,探讨变量a与幕上肿瘤继发癫痫的易感性。结果①术前变量a在幕上肿瘤患者中的出现率为56.86%。②术前变量a在A组中的出现率高于B组(66.23%vs 52.81%,P<0.05);A、B两组变量b和a+b出现率比较差异均有显著性(29.87%vs 9.55%,66.23%vs 7.30%,P<0.05)。进一步分析两变量之间癫痫发生率的差异显示:A组中出现变量a+b略高于变量b(P<0.05)。③术后45例出现早期癫痫,其中35例(77.78%)AEEG中描记到变量a或变量a+b,将术后双侧同步节律性慢波的出现率与术后癫痫发作率进行一致性分析得知两者有高度一致性(k=0.600 2)。结论双侧同步节律性慢波可能增加幕上肿瘤患者癫痫发作的易感性。

Susceptibility of bilateral synchronous rhythmic slow wave in secondary epilepsy in patients with intracranial tumor

Objective To determine the susceptibility of bilateral synchronous rhythmic slow wave displayed in the active electroencephalography(AEEG) in the secondary epilepsy in patients with intracranial tumors.Methods Bilateral synchronous rhythmic slow wave displayed in the AEEG of 255 patients with intracranial tumors who admitted in our hospital from Jan.2008 to Jul.2010 were retrospectively analyzed.These patients were divided into 2 groups,group A(patients with preoperative epileptic seizures) and group B(with no preoperative epileptic seizure).The bilateral synchronous rhythmic slow wave in the AEEG was defined the as variable a,epileptiform discharge was used as a reference object,and epileptiform discharge in the AEEG was defined as variable b.Then both bilateral synchronous rhythmic slow wave and epileptiform discharge in the AEEG was defined as variable a+b.The difference of the 3 variables were analyzed in group A and B,and the relationship of variable a with the secondary epilepsy in patients with intracranial tumor was mainly explored.Results The occurrence rate of variable a in patients with intracranial tumor was 56.86%(145/255).Before the operation,the occurrence rate of variable a in Group A was 66.23%(51/77),while that in Group B was 52.81%(94/178),with that in the former was significantly higher than that in the later group(P<0.05).And the occurrence rate of variable b in group A and group B were 29.87%(23/77) and 9.55%(17/178) respectively,while that of variable a+b were 66.23%(51/77) and 7.30%(13/178) respectively.Both variable b and variable a+b showed great significance in group A and group B(P<0.05).Further analysis on the difference in the occurrence of seizures between the two variables showed that the occurrence rate of variable a+b was obviously higher than that of variable b in Group A(P<0.05).There were 45 patients having early postoperative epilepsy,and 35(77.78%) of them recorded to variable a or variable a+b in the AEEG.Consistency analysis showed that the occurrence rate of postoperative bilateral synchronous rhythmic slow wave were in high consistency with that of postoperative epilepsy(k=0.600 2).Conclusion Bilateral synchronous rhythmic slow wave may increase the susceptibility of the secondary epilepsy in patients with intracranial tumors.