发作期及发作间期痫性放电对癫痫的诊断价值

目的探讨发作期及发作间期脑电图对癫痫诊断的意义。方法对５６例癫痫患者常规脑电图（ＲＥＥＧ）与２４ｈ脑电图（ＡＥＥＧ）进行比较研究。结果①ＲＥＥＧ的阳性率为３０％，而ＡＥＥＧ的阳性率为８６％；②不同类型癫痫在发作期和发作间期大脑活动的规律和特点，ＲＥＥＧ无１例记录到癫痫发作，而ＡＥＥＧ有２７例（４８％）记录到癫痫发作全过程的大脑电活动变化。结论发作期的ＥＥＧ对确定癫痫类型有重要意义，全身性癫痫在发作的同时发作波在两侧半球同时出现，而部分性发作患者在临床发作的同时ＥＥＧ常局限在某一脑叶有单个棘波发放，此棘波处是癫痫的病灶的部位，这种局限棘波可扩散至全脑而临床出现全身阵挛发作，此类患者为部分性癫痫并非全身性癫痫。

The diagnostic value of ictal and interictal epileptiform discharge in epilepsy.

Objectives To explore the value of ictal and interictal epileptiform activity.Methods The routine EEG and 24 hour ambulatory cassette EEG were compared in 56 patients with epilepsy.Results (1)The positive rate of routine EEG was 30%,but the AEEG was 86%.(2)EEG characteristics of ictal and interictal epileptiform activity with different classification was analysed.There was not ictal epileptiform record in REEG,conversly,27 ictal epileptiform records in AEEG.The EEG activity of the whole seizure process was analyzed. Conclusions Ictal epileptiform discharges were very important for epilepsy classification.The ictal wave appeared on bilateral cerebral hemisphere simultaneously in generalized epilepsy.The local spike wave was limited at some cerebral lobe for partial epilepsy.The site of the spike wave was epileptogenic focus.The patient with focal spike wave expanded to bilateral cerebral hemisphere at the same time of tonic-clonic seizure was partial epilepsy and was not generalized one.