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纸质出版日期:2018,
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脑电图及神经影像学在小儿热性惊厥中的临床应用价值[J]. 重庆医科大学学报, 2018,43(2):192.
Clinical value of electroencephalogram and neuroimaging in children with febrile seizures[J]. Journal of Chongqing Medical University, 2018,43(2):192.
目的:探讨脑电图(electroencephalogram,EEG)及神经影像学(computed tomography,CT或magnetic resonance imaging,MRI)检查在小儿热性惊厥(febrile seizures,FS)中的临床应用价值。方法:①根据临床特征将FS分为单纯性热性惊厥(simple febrile seizures,SFS)和复杂性热性惊厥(complex febrile seizures,CFS);根据随访结果,分为FS继发癫痫组与FS未继发癫痫组;②426例FS儿童于发作后2周内行首次EEG,并根据病情定期随访,92例行CT,310例行MRI,采用卡方检验和logistic回归分析,分析总结EEG、CT或MRI与FS类型、临床特征以及是否继发癫痫的关系。结果:①FS儿童首次EEG异常71例,随访后异常138例,两者比较有明显差异(P=0.000);其中SFS组和CFS组分别由22例、49例增至26例、112例,复查前、后比较,SFS组无明显差异(P=0.102),CFS组有明显差异(P=0.008);②根据随访结果,EEG异常率在SFS组(26/426)与CFS组(112/426)间、FS继发癫痫组(97/127)与FS未继发癫痫组(41/299)间比较存在明显差异(P=0.001,P=0.001);③CT、MRI异常率在SFS组(CT,8/92;MRI,9/310)与CFS组(CT,5/92;MRI,28/310)间、FS继发癫痫组(CT,3/16;MRI,16/110)与FS未继发癫痫组(CT,10/76;MRI,21/200)间比较均无明显差异(P=0.574,P=0.755,P=0.559,P=0.293);④CT/MRI与EEG检查异常率之间无相关性(P=0.836,P=0.557)。结论:①对CFS儿童定期随访EEG有较大的临床应用价值,但对SFS儿童其价值有限;②CT/MRI对发育正常的FS儿童的临床应用价值有限,不需要常规进行。
Objective:To explore the clinical value of electroencephalograms(EEG) and neuroimaging(CT or MRI) in children with febrile seizures(FS). Methods:①According to clinical features,the children with FS were classified as simple febrile seizures(SFS) and complex febrile seizures(CFS). According to the follow-up results,the children with FS were classified as children with epilepsy group and children without epilepsy group. ②The initial EEGs were recoreded within two weeks after onset in 426 children with FS. And EEGs were followed up regularly. A total of 92 children with FS underwent CT and 310 underwent MRI. Chi-square test and Lo-gistic regression analysis were used to analyze the relationship between EEG,CT/MRI and types of FS,clinical features,and sec-ondary epilepsy. Results:①The abnormal cases of initial EEGs and follow-up EEGs were 71 and 138 respectively,with significant differences(P=0.000). The abnormal cases of EEG in SFS group and CFS group ranged from 22 to 26,from 49 to 112 respectively. Compared with follow-up results before and after,there was no significant difference in SFS group(P=0.102),and the difference was significant in CFS group(P=0.008). ②In the follow-up results,the abnormal rate of EEGs were significant different in SFS group (26/426) and CFS group(112/426),children with epilepsy group(97/127) and in children without epilepsy group(41/299)(P=0.001,P=0.001). ③The abnormal rate of CT/MRI were not significant different in SFS group(CT,8/92;MRI,9/310),CFS group(CT,5/92;MRI,28/310),children with epilepsy group(CT,3/16;MRI,16/110) and in children without epilepsy group(CT,10/76;MRI,21/200)(P=0.574,P=0.755,P=0.559,P=0.293). ④The abnormali-ties of CT/MRI were not correlated with the abnormalities of EEG(P=0.836,P=0.557). Conclusion:①EEG,especially the regular follow-up of EEG,has a greater clinical value for chil-dren with CFS,and is of limited value for children with SFS. ②CT/MRI has limited clinical value in neurologically normal chil-dren with FS,and the routine examination is not justified.
热性惊厥单纯性热性惊厥复杂性热性惊厥脑电图神经影像学癫痫
febrile seizuressimple febrile seizurescomplex febrile seizureselectroencephalogramneuroimagingepilepsy
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