视频脑电图在新生儿惊厥中的诊断意义探讨

目的探讨视频脑电图(VEEG)在新生儿惊厥中的诊断意义。方法对首次疑为癫痫性发作的130例新生儿惊厥者进行4~6 h VEEG监测,对其脑电波形及临床发作情况进行分析,监测3~5年。对于重度及中度癫痫性发作患儿给予口服鲁米那或托吡酯治疗。结果首次视频脑电图异常率90.8%(118/130),癫痫性发作48例(重度11例,中度15例,轻度22例),非癫痫性发作70例。治疗2~4周VEEG异常率75.4%(98/130),癫痫性发作40例,非癫痫性发作58例。随访3~5年癫痫性发作22例(16.9%),非癫痫性发作0例。结论在新生儿惊厥的临床诊断及鉴别诊断,区别癫痫性发作与非癫痫性发作及对癫痫患儿的治疗和预后判断上,VEEG是有重要意义的指标。

Diagnostic significance of Video-EEG for neonatal seizures

Objective To discuss diagnostic value and significance of Video-EEG(VEEG) for neonatal seizures.Methods Monitoring of VEEG was performed on 130 neonatal seizure patients doubtful epileptic seizure for 4 to 6 hours,and these informations of electroencephalographic waves and clinical epileptic seizure were analyzed.Followed-up monitoring was performed for 3 to 5 years,giving topiramate to the child patients who have serious and midrange epileptic seizure.Results The abnormal rate of first VEEG was 90.8%,Epileptic seizure patients were 48 cases,and 11 patients were serious,15 cases in midrange,22 cases in light among them.Non-epileptic seizure patients were 70 cases(53.8%).After treating for 2 to 4 weeks,the abnormal rate of VEEG was 75.4%,the epileptic seizure patients were 40 cases(30.8%),and non-epileptic seizure patients were 58 cases(44.6%)in them.Following-up these patients for 3 to 5 years,epileptic seizure patients were 22 cases(16.9%),and no case was in non-epileptic seizure.Conclusions VEEG is a very important index for neonatal seizure patients in clinical diagnosis and differential diagnosis,epileptic seizure and non-epileptic seizures,and it is also very important to neonatal seizure patients in treatment,follow up and judging prognosis.