脑电图在高原脑水肿早期的表现及诊断价值

目的探讨脑电图在高原脑水肿早期的主要表现及其诊断价值。方法根据高原反应症状评分以及典型症状对24200例急进高原人员进行筛查,对其中162例高原脑水肿疑似病例进行观察随访及脑电图检查,并结合高原脑水肿的发病情况进行分析。结果在本组高原脑水肿疑似病例中,36例患者最后确诊为高原脑水肿,必须住院治疗。其中25例患者在未出现显著精神、神经症状前即出现了脑电图异常,主要表现为轻度或中度慢波性异常;但在未发生高原脑水肿的观察对象中亦有48.4%患者出现类似的脑电图改变。结论高原脑水肿早期的脑电图异常表现主要为慢波性异常,包括高波幅θ活动明显增多、中等量δ活动、枕区基本节律明显减慢等,偶有高波幅β活动增多,但脑电图对高原脑水肿早期诊断缺乏特异性及敏感性。

Manifestations and Diagnostic Value of EEG in the Early Stage of High Altitude Cerebral Edema

Objective To explore the electroencephalogram （EEG） characteristics in the early stage of high altitude cerebral edema （HACE） and its value for the early diagnosis of HACE.Methods In 24 200 people who immediately entered into high altitude plateau in the recent two years,162 with high suspects of HACE were selected as observation subjects for their symptoms and EEG manifestations with follow-up.The results of observation,follow-up and electroencephalographic examination were analyzed in combination with incidence of HACE.Results Thirty-six subjects were finally diagnosed as HACE patients with a need of inhospital treatment.Twenty-five patients had abnormal EEG manifestation before obvious mental or nervous symptoms.The main manifestations were the slight or mild increase of slow waves with similar changes being observed in 48.4% subjects without HACE.Conclusion The main EEG manifestations in the early stage of HACE are increase of slow waves,including θ or δ activity,obvious slowdown of basic rhythm in the occipital,and occasionally higher amplitude β activity.However,EEG has low specificity and sensitivity for the early diagnosis of HACE.