病毒性脑炎脑电图及影像学特点分析

目的 探讨病毒性脑炎患儿的脑电图及影像学特点.方法 对2011年6月至2013年6月在湖南省儿童医院治疗的20例重症病毒性脑炎的脑电图、影像学及脑脊液检查结果进行回顾性分析.结果 20例患儿脑电图检查均有不同程度异常,且脑电图异常随病情的进展而变化,早期表现为背景节律慢化,波幅降低.脑脊液异常表现为压力增高10例,白细胞轻度增高6例,以淋巴细胞增高为主,蛋白轻度增高5例.脑脊液细菌培养均阴性,特异性病毒抗体检测仅2例阳性,均为单疱病毒.11例MRI异常.病变大多呈双侧对称性,少数病灶不对称.其中病变累及1个部位者4例（41.6％）.基底节异常信号6例,额叶3例,脑干5例,大脑脚2例,中脑2例,枕区异常信号3例,视神经受损2例.5例CT正常而MRI表现为小脑、脑干异常信号,增强扫描均无明显强化,3例MRI脑、脊髓均有异常信号,且临床亦同时有脊髓炎的表现.结论 病毒性脑炎患儿脑电图均有异常,脑电图改变的程度与患儿病情严重程度相关,随病情的好转而好转.脑电图对病毒性脑炎早期诊断及判断预后有重要意义.

Characteristics of electroencephalogram and images of viral encephalitis

Objective To analyze characteristics of electroencephalogram （EEG） in children with viral encephalitis.Methods The EEG,image and cerebrospinal fluid of 20 children with severe viral encephalitis were retrospectively analyzed at Hunan Children＇s hospital from June 2011 to June 2013.Results Totally 20 cases of children had EEG examination.Abnormal EEG was associated with the progress of the disease.Early EEG showed slower rhythm and lower volatility.10 cases had increasing cerebrospinal fluid pressure.Cerebrospinal fluid bacterial cultures were all negative.Magnetic resonance imaging（MRI） of 11 cases was abnormal ; most lesions were bilateral symmetry.4 cases（41.6%） had one lesion.There were 6 patients with abnormal signal in basal ganglia,3 patients in the frontal lobe,5 patients in the brain stem,2 cases in cerebral peduncle,2 cases in midbrain and 3 cases in the occipital.Conclusion Severe viral encephalitis in children shows abnormal EEG which changes with the severity and development of the disease.