癫痫的多导睡眠研究

目的:了解癫痫放电在自然睡眠各期及觉醒状态下分布情况,为癫痫的诊断与优化治疗提供客观参考依据。方法:筛选40例全身性强直—阵挛发作尚未用AEDs治疗的癫痫患者,用英国OXFORD Medilog 9200型动态脑电监测仪同时进行多导睡眠记录和动态脑电图记录。结果:40例中有33人记录到典型癫痫波(82.5%),30人记录到慢波阵发(75%),11人记录到α高尖阵发(27.5%)。结论:本研究提示典型癫痫放电和慢波发放主要在W和S_(1,2)较多,其次是在REM,在S_(3,4)相对较少,α高尖阵发主要是在W和S_(1,2),这说明痫样放电在觉醒和睡眠时均有相当的放电时间和次数。本研究还提示通过动态脑电图检测或结合多导睡眠图可详细准确了解痫样放电的24小时分布状况,对指导调整AEDs的用量和服用时间,实现癫痫优化治疗有重要意义。

Polysomnographic Study of Epilepsy

Objectives; To find out the distributive pattern of epileptiform discharges in different sleep stages and wakefulness and give guidance to the diagnosis and optimized treatment of epilepsy. Methods; We screened out 40 clinically diagnosed epileptic patients with no medication of AEDs and simultaneously recorded 24 hrs EEG and polysomnogram with OXFORD Medilog 9200 ambulatory EEG system. Results: 33 cases (82. 5%) were found to have typical epileptic discharges during recording, 30(75%), slow wave bursts, 11(27%), sharp high a bursts. Conclusions; Our study showed that the typical epileptic discharges and slow wave bursts appeared mainly in S1,2 and Wakefulness, and then in REM, less in S3,4 the sharp high a bursts mainly in w, S1.2 and lack in S3,4. Therefore atttention should be equally paid to wakefulness and sleep (especially S1,2). Our results may indicate that the medication of AEDs can be optimezed necording to distuibution paterns of epileptiform discharges during long-term EEG monitoring.