动态脑电图辅助指导神经外科术后预防性抗癫痫药物减停的价值

目的探讨动态脑电图(AEEG)辅助指导神经外科术后预防性抗癫痫药物减停的临床价值。方法回顾性分析郑州大学第五附属医院2013-01—2018-12收治的神经外科术后预防性抗癫痫药物减停后发作患者121例及同期未发作患者145例的临床资料,比较2组慢波和棘尖波发生情况,同时分析病情控制组和未控制组脑电图波形。结果发作组治疗后R型、R-M型及S型比例均显著低于未发作组(P<0.05);发作组治疗后M型、M-L型、L型及P型比例均显著高于未发作组(P<0.05);发作组患者脑电图NS和RS比例均显著低于未发作组(P<0.05);发作组患者脑电图MS和LS比例均显著高于未发作组(P<0.05)。病情控制组脑电图NS和RS比例均显著高于病情未控制组(P<0.05);病情控制组患者脑电图MS和LS比例均显著低于病情未控制组(P<0.05)。结论AEEG用于神经外科术后预防性抗癫痫药物减停指导具有一定临床价值,其中存在M型慢波、M-L型慢波、L型慢波、P型慢波、MS型棘尖波及LS型棘尖波者停药后出现癫痫发作风险更高。

The guidance value of AEEG in prophylactic antiepileptic drug withdrawal after neurosurgery

Objective To investigate the guidance value of AEEG in prophylactic antiepileptic drug withdrawal after neurosurgery.Methods Clinical data of 121 patients with occurrence of prophylactic antiepileptic drugs after neurosurgery and 145 patients without occurrence of prophylactic antiepileptic drugs after neurosurgery were chosen in the period from January 2013 to December 2018 in our hospital and the occurrence of slow wave and spike wave of 2 groups were compared,and the difference of EEG waveforms between the disease control group and the uncontrolled group was analyzed.Results The proportions of R-type,R-M-type and S-type of seizure group were significantly lower than non-seizure group after treatment(P<0.05).The proportions of M-type,M-L-type,L-type and P-type of seizure group were significantly higher than non-seizure group after treatment of observation group were significantly better than control group(P<0.05).The proportion of NS and RS in EEG of patients with seizure group were significantly lower than non-seizure group(P<0.05).The proportion of MS and LS in EEG of patients with seizure group were significantly higher than non-seizure group(P<0.05).The proportion of NS and RS in EEG of patients with disease control was significantly higher than without disease control(P<0.05).The proportion of MS and LS in EEG of patients with disease control were significantly lower than without disease control(P<0.05).Conclusion AEEG possess certain clinical value in the guidance of prophylactic antiepileptic drug withdrawal after neurosurgery.Patients with M-type slow wave,M-L slow wave,L-type slow wave,P-type slow wave,MS-type spike wave and LS-type spike wave should be the higher risk of epilepsy seizures after discontinuation of drugs.