视频脑电图对儿童非癫癎性发作疾病的诊断价值

【目的】 探讨视频脑电图(video electroencephalography, VEEG)监测对儿童非癫癎性发作疾病(video electroencephalography, NES)的诊断价值。 【方法】 本院儿科视频脑电图室于2009年9月-2011年2月期间,对来280例拟诊或需排除癫病患儿进行了视频脑电图监测,结合视频脑电图监测结果、临床症状、体征、头颅CT 、血液生化检查(包括血糖、血氨、心肌酶谱) 等病史特点得到NES确定诊断,分析VEEG检查对儿童NES的诊断价值。 【结果】 75例(26.79%)判定为非癫癎性发作,非癫癎性发作类型包括:心因性NES为13例(17.3% ):癔病样发作6例(8.0%),情绪障碍5例(6.7%),屏气发作2例(2.6%)。躯体性NES为62例(82.7%):非癫癎性强直发作16例(21.3%);睡眠障碍11例(14.7%);良性肌阵挛10例(13.3%);头痛7例(9.3%);抽动症6例(8.0%);轻度胃肠炎伴发婴幼儿良性惊厥4例(5.3%);头晕4例(5.3%);良性非癫癎性婴儿痉挛3例(4.0%);脑瘫及运动发育迟缓肌张力增高导致异常动作1例(1.3%)。 【结论】 视频脑电图对诊断与鉴别诊断非癫癎性发作有重要临床意义。

Diagnostic value of video electroencephalography in children with nonepileptic seizures

【Objective】 To explore the diagnostic value of video electroencephalography(VEEG) in children with non-epileptic seizure. 【Methods】 From Sep.2009 to Feb.2011,280 children suspected to have or need to weep out the possibility of epilepsy were examined with VEEG.Then the confirmed diagnosis of non-epileptic seizures(NES) would be made by VEEG,clinical symptoms,physical signs,ECG,CT of the skull,and blood examination(such as blood sugar,blood ammonia,myocardial enzyme).Then the diagnostic value of VEEG in children were evaluated with non-epileptic seizure. 【Results】 75 children were diagnosed as NES.13(17.3%) NES children were associated with psychogenic disorders,including 6 hysteria sample attacks(8.0%),5 emotional disturbance(6.7%),and 2 breath-holding spells(2.6%).62(82.7%) NES children were associated with somatoform disorders,including 16 non-epileptic tonic seizures(21.3%),11 sleep disorders(14.7%),10 benign myoclonus(13.3%),7 headache(9.3%),6 tourette syndrome(8.0%),4 benign convulsion associated with gastroenteritis(5.3%),4 dizziness(5.3%),3 benign myoclonus of early infancy(4.0%),and 1 abnormal posture related to cerebral palsy(1.3%). 【Conclusion】 VEEG has important clinical significance for diagnosis and differential diagnosis of NSE.