脑电与心电同步检测对癫痫性与心律失常性晕厥的鉴别诊断价值

目的 :探讨 2 4小时脑电 /心电同步监测对癫性晕厥和心律失常性晕厥的诊断和鉴别诊断价值。方法 :对 72例临床怀疑癫性晕厥和心律失常性晕厥患者进行 2 4小时动态脑电图 (AEEG) /心电图 (ECG)同步监测。结果 :①癫性晕厥 42例中 ,EEG总异常率 83 91%。样放电出现率71 2 4% ;心电图显著异常率 19% ;②心律失常性晕厥 2 1例中 ,EEG总异常率 2 4% ,样放电出现率 5 % ,心电图显著异常 91% ;③可疑癫性晕厥 4例中 ,AEEG样放电 1例 ;④可疑心律失常性晕厥 3例 ,ECG均为非显著异常 ;⑤晕厥原因不明 (癫与心律失常两种疾病并存 ) 2例 ,均检出样放电及显著心律失常。结论 :2 4小时EEG/ECG同步监测对癫性晕厥和心律失常性晕厥有重要的诊断和鉴别诊断的价值。

Differentiatial diagnostic value of simultaneous EEG/ECG monitoring in patients with epileptic syncope and arrhythmic syncope.

Objectives: To explore the diagnostic value of 24-hour simultaneous electroencephalography (EEG)/electrocardiography (ECG) monitoring in patients with epileptic and arrhythmias syncope.Methods: Seventy-two patients with syncope by either epilepsy or arrhythmias were evaluated by 24-hour simultaneous EEG/ECG monitoring.Results: Forty-two patients with epileptic syncope were found. The total abnormality rate was 83% and the rate of epileptiform discharges was 71% by AEEG, The rate of significant abnormality of ECG was 19%, Arrhythmic syncope was noted in 21 patients. The rate of significant abnormal ECG was 91%. Abnormality rate of EEG was 24% and epileptiform discharge rate was 5%. In four patients with syncope by suspected epilepsy, one showed epileptiform discharges and the other three ones showed nonspecific abnormatities, no significant abnormality was found on ECG. Three patients with syncope by suspectecl arrhythmia showed significant abnormal ECG and no abnormality was noted on EEG. Two cases with syncope without definite causes showed epileptiform discharges and arrhythmia was detected. Conclusions:24-hour simultaneous EEG/ECG monitoring might be of an important diagnostic and differentiatial diagnostic value in syncope caused by either epilepsy or arrhythmias, or both.