儿童失神性癫痫EEG放电昼夜规律的探讨

对３例原发性失神性癫痫患儿进行２４ｈ痫样放电的定量分析。结果表明，非快速眼动（ＮＲＥＭ）睡眠期痫样放电频度较醒觉期显著增多，而每次放电持续时间显著缩短，放电失去全导同步３Ｈｚ节律性爆发的特征，表现为不规则棘慢波、多棘慢波以杂乱无序的形式出现，以前头部为主，多种放电现象可出现于同一患儿的同一睡眠相。提示儿童原发性失神性癫痫可能系皮层多位点起源，并受到丘脑等皮层下结构的调控。其脑电的去同步化可能对皮层的放电有抑制作用。ＮＲＥＭ睡眠期可能在皮层水平触发多处放电。临床上，２４ｈＥＥＧ监测可定量检出临床发作及放电频率，正确判断睡眠中的异常放电，确定抗癫痫药物的治疗效果。

The pattern of EEG discharges during day and night in childhood absence epilepsy

Twenty-four hour quantitatve analysis of epileptiform discharges were performed on 3 patients with childhood absence epilepsy. The results showed that the epileptiform discharges increased in frequency and shortened in period of each burst in NREM sleep stages. The characteristics of 3Hz bursts synchronously are disrupted into a number of irregular or local spike or polyspike and waves. The variant patterns of discharge could be found in The same sleep stage of an individual child. The phenomenon susgested that the discharges of absence may be originated from diffrenent areas of cortex and were moderated by thalamencephalon and other subcortical structures. Asynchronism of EEG in wake and REM sleep probably inhibited the cortical discharges and the discharges may be triggered in multi-sites of the cortex in NREM sleep stages. Twenty-four hour EEG monitoring could find clinical absence seizures and subclinical discarges quantitvely. distinguish the discharges during sleep and determine the effect of antiepileptic drugs.