振幅整合脑电图对新生儿惊厥的诊断及预后价值

目的探讨振幅整合脑电图(aEEG)对新生儿惊厥的诊断及预后价值。方法选取2018年6月至2019年11月东莞市人民医院收治的51例惊厥或可疑惊厥发作新生儿作为研究对象,进行aEEG检查,同时记录原始视频脑电图(VEEG)。记录一般资料、发作情况、aEEG、VEEG结果及预后。结果共纳入51例新生儿,其中35例新生儿监测到发作性事件,12例为非癫痫性事件,23例为经VEEG确诊临床电发作或电发作。aEEG监测到阵发性异常19例,以VEEG为标准,aEEG识别惊厥患儿的敏感性为82.6%(19/23)。aEEG异常28例(54.9%),其中轻度异常18例,重度异常10例;轻度异常以阵发性异常为主,重度异常以背景活动异常为主;aEEG重度异常患儿背景活动均异常(100.0%),背景异常率高于轻度异常患儿,差异有统计学意义(P<0.05)。背景异常患儿运动发育迟缓率高于背景正常患儿,差异有统计意义(P<0.05);aEEG不同异常程度患儿运动发育迟缓发生率比较,差异有统计学意义(P<0.05)。结论aEEG诊断新生儿惊厥的敏感性高,可以作为早期筛查新生儿惊厥的重要依据,并且预测远期运动发育的不良结局。

Clinical value of amplitude-integrated electroencephalography on the diagnosis and prognosis of neonatal seizure

Objective To investigate the clinical value of amplitude-integrated electroencephalography(aEEG)on the diagnosis and prognosis of neonatal seizure.Methods From June 2018 to November 2019,51 neonates with seizure or with suspicious seizures admitted to Dongguan People’s Hospital were selected as the research subjects for aEEG examination,and the original video electroencephalogram(VEEG)was recorded at the same time.The clinical data,seizure type,aEEG,VEEG results and prognosis were recorded.Results Among the 51 neonates,35 cases of neonatal convulsions were detected,12 case were non epileptic events,while 23 cases were seizures or only epileptic seizures.aEEG showed 19 paroxysmal discharge,sensitivity of seizure detection was 82.6%(19/23)for aEEG using VEEG as the standard.28 cases(54.9%)had abnormal aEEG results,including 18 mildly abnormal cases and 10 severely abnormal cases.The characteristics of mildly abnormal aEEG was paroxysmal abnormal activities,and severely abnormal aEEG was delayed mature.All of the severely abnormal aEEG showed abnormal background activities(100.0%).The incidence of abnormal background activities of severely abnormal group was higher than that of mildly abnormal group,the difference was statistically significant(P<0.05).Neonates with abnormal background activities had higher rates of delayed maturation than those with normal background,and the differences were statistically significant(P<0.05).There was a statistically significant difference in the incidence of delayed maturation among children with different degree of aEEG abnormality(P<0.05).Conclusion aEEG has high sensitivity in the diagnosis of neonatal seizure.It could be used as a screen for neonatal seizure.aEEG has import ant predictive value for motor retardation.