摘要
目的探讨老年癫痫视频脑电图的特点。方法选取2013年6月-2014年7月期间接受视频脑电图监测的年龄〉16岁的癫痫患者为研究对象。将57例老年癫痫患者（老年组,≥60岁）和65例非老年成人癫痫患者（对照组,16-59岁）进行视频脑电图监测,要求监测的24 h必须经历清醒期及自然睡眠期,并行过度换气试验。比较两组发作间期癫痫样放电检出率、过度换气时异常反应率及分析发作期的脑电图特点。结果 1发作期两组均有以下波形：广泛性低幅快波[（老年组2例（7.4%）,对照组4例（12.5%）]、局部性低幅快波[老年组5例（18.5%）,对照组6例（18.8%）]、广泛性棘波或棘慢复合波[（老年组3例（11.1%）,对照组7例（21.8%）]、局部性棘波或棘慢复合波[（老年组5例（14.9%）,对照组8例（25.0%）]、局灶性节律性慢波[（老年组6例（18.5%）,对照组6例（18.8%）]。其中老年组出现了：仅有背景活动异常5例（18.5%）、既无背景活动异常也无癫痫样放电1例（3.7%）两种表现。发作期老年组的局灶性癫痫样放电[16例（59.3%）]多于对照组[8例（25.0%）],两组比较差异有统计学意义（P〈0.05）。2发作间期老年组的癫痫样放电检出率（清醒期15.8%,睡眠期52.6%）低于对照组（清醒期46.2%,睡眠期83.1%）,差异有统计学意义（P〈0.05）,且可见局灶性慢波（颞区间断节律性δ活动9例）。3自然睡眠中老年组癫痫样放电出现率增多（65.3%）。4老年组的过度换气异常反应出现率（14.0%）低于对照组（64.6%）,两组比较差异有统计学意义（P〈0.05）。结论老年癫痫发作起始期脑电表现与非老年成人类似,但有以下2种特殊情况：1仅有背景活动异常;2既无背景活动异常,也无癫痫样放电。老年人发作期脑电波为局灶性起始的更多。自然睡眠中老年人癫痫样放电出现率增多。老年人过度换气的异常反应不敏感。
Objective To investigate the video-electroencephalography（VEEG） characteristics of old patients with epilepsy（OPWE）.Methods Between June 2013 and July 2014,57 OPWE at an age over 60 years were assigned to research group and 65 adults between 16 and 60 years old with epilepsy were regarded as controls.All the subjects underwent VEEG for 24 hours covering awake state and sleep with hyperventilation test being applied.Chi square was used to compare occurrence rate of epileptic wave and abnormal response rate after hyperventilation between the two groups of patients.Additionally,ictal elcetroencephalograph（EEG） was analyzed.Results Common features of waves on EEG for patients in both the two groups during the ictal period included widespread low amplitude fast wave（2 cases in the research group,7.4%;4 cases in the control group,12.5%）,focal low amplitude fast wave（5 cases in the research group,18.5%;6 cases in the control group,18.8%）,widespread spike or spike slowing complex（3 cases in the research group,11.1%;7 case in the control group,21.8%）,focal spike or spike slowing complex（5 cases in the research group,14.9%;8 cases in the control group,25.0%）,and focal rhythmic slow wave（6 cases in the research group,18.5%;6 cases in the control group,18.8%）.In the research group,there were two following cases：single abnormal background activity in 5 cases（18.5%）,and neither abnormal background activity nor epileptic discharge in 1 case（3.7%）.Ictal focal epileptic discharges were found in 16 cases in the research group and 8 in the control group（59.3%vs 25.0%）,with statistical difference（P〈0.05）.Inter-ictal epilepsy discharges were found in 57 patients of the research group（awake,15.8%;sleep,52.6%）,which was less than that in the control group（awake,46.2%;sleep,83.1%） with statistical difference（P〈0.05）,accompanied by focal slow wave（temporal intermittent rhythmic delta activity,TIRDA） in 9 cases.In natural sleep period,epilepsy discharge occurrences increased（65.3%）.Abnormal response rate in the research group（14.0%） was lower than that in the control group（64.6%） with statistical difference（P〈0.05）.Conclusions Early onset EEG of the old and the adult are similar except those with single abnormal background activity and those with neither abnormal background activity nor epileptic discharge.Focal onset on EEG is more frequently seen in OPWE than in APWE.In natural sleep,epileptic discharge increases among OPWE,and abnormal response during hyperventilation is less likely to happen in OPWE.
出处
《华西医学》
CAS
2015年第4期613-617,共5页
West China Medical Journal
关键词
视频脑电图
脑电图
老年癫痫
Video electroencephalogram
Electroencephalography
Old patients with epilepsy
作者简介
林燕（1979-），女，四川成都人，主治医师，在读硕士，Email：7225422@qq．com.
通讯作者：刘凌，Email：zjllxx1968@163．com
