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头皮脑电图波型对动脉瘤性蛛网膜下腔出血继发癫痫的预测价值
Predictive value of scalp electroencephalogram patterns for secondary epilepsy after aneurysmal subarachnoid hemorrhage
- 第三军医大学学报 2018年40卷第15期 页码：1383-1388
- 作者机构：
400016 重庆, 重庆医科大学附属第一医院神经外科
- 作者简介：
[ 谢延风, E-mail:Xyf3058@163.com XIE Yanfeng, E-mail:Xyf3058@163.com
- 基金信息：国家临床重点专科建设项目经费资助((2011)170号);重庆市卫生局重点课题(2012-1-008)
DOI：10.16016/j.1000-5404.201712273
中图分类号： R741.044;R742.41;R743.35收稿：2017-12-28，
修回：2018-03-27，
纸质出版：2018-08-15
- 稿件说明：
移动端阅览
廖兴甫, 但炜, 孙超, 等. 头皮脑电图波型对动脉瘤性蛛网膜下腔出血继发癫痫的预测价值[J]. 第三军医大学学报, 2018,40(15):1383-1388.
Xingfu LIAO, Wei DAN, Chao SUN, et al. Predictive value of scalp electroencephalogram patterns for secondary epilepsy after aneurysmal subarachnoid hemorrhage[J]. Journal of Third Military Medical University, 2018, 40(15): 1383-1388.
廖兴甫, 但炜, 孙超, 等. 头皮脑电图波型对动脉瘤性蛛网膜下腔出血继发癫痫的预测价值[J]. 第三军医大学学报, 2018,40(15):1383-1388. DOI： 10.16016/j.1000-5404.201712273.
Xingfu LIAO, Wei DAN, Chao SUN, et al. Predictive value of scalp electroencephalogram patterns for secondary epilepsy after aneurysmal subarachnoid hemorrhage[J]. Journal of Third Military Medical University, 2018, 40(15): 1383-1388. DOI： 10.16016/j.1000-5404.201712273.
摘要
目的
2
分析动脉瘤性蛛网膜下腔出血（aneurysmal subarachnoid hemorrhage，aSAH）头皮脑电图（electro-encephalogram，EEG）的特点，比较EEG不同波形特征与aSAH继发癫痫的关系，探讨头皮脑电图波型对aSAH后癫痫发生的预测价值。
方法
2
回顾性分析我院神经外科2014年1月至2017年1月312例aSAH患者脑电图资料，出院后平均随访半年以上。按照有无癫痫发作分为：发作组和非发作组。按癫痫发生时间分为早期癫痫组和晚期癫痫组。将头皮脑电图波形分为：Ⅰ型（正常脑电图）、Ⅱ型（慢波类型）、Ⅲ型（爆发性慢波类型）、Ⅳ型（典型棘尖波类型）和Ⅴ型（电发作类型），分别比较各组的头皮脑电图波形特征。
结果
2
① 312例aSAH患者中有44例诊断为癫痫，其癫痫发生率为14.1%，其中早期癫痫24例（7.7%），晚期癫痫20例（6.4%）。②发作组和非发作组患者脑电图类型构成比差异存在统计学意义（
P
<
0.01）。发作组中脑电图类型以Ⅲ型和Ⅳ型为主（84.1%），非发作组以Ⅱ型为主（79.5%）。发作组中，Ⅲ型、Ⅳ型和Ⅴ型的比例（95.5%）显著高于非发作组（19.0%）。③早期癫痫组和晚期癫痫组患者脑电图类型构成比差异存在统计学意义（
P
<
0.01），早期癫痫组以Ⅲ型最多（70.8%），晚期癫痫组以Ⅳ型最多（80.0%）。
结论
2
头皮脑电图对动脉瘤性蛛网膜下腔出血继发癫痫有一定的预测价值，Ⅲ型、Ⅳ型和Ⅴ型为aSAH继发癫痫的高危波型；Ⅲ型、Ⅳ型可能分别与早、晚期癫痫有关。
Abstract
Objective
2
To analyze the characteristics of scalp encephalogram (EEG) in the patients of aneurysmal subarachnoid hemorrhage (aSAH)
compare the relationship of different brain wave patterns with secondary epilepsy after aSAH
and assess the predictive value of EEG patterns for epilepsy.
Methods
2
A retrospective study was performed on the EEG data of 312 aSAH patients admitted in our department from January 2014 to January 2017. All patients were followed up for over half a year. According to the presence of epileptic seizures
the patients were divided into seizures and non-epileptic seizure groups. The former group were also assigned into early epileptic group and late epileptic group based on the time of seizure. The EEG morphological patterns were divided into type Ⅰ (normal EEG)
type Ⅱ (slow wave type)
type Ⅲ (explosive slow wave type)
type Ⅳ (typical spikes sharp wave type)
and type Ⅴ (electrographic seizure). The EEG patterns were compared in different groups.
Results
2
① In the 312 aSAH patients
there were 44 patients with epilepsy
with an incidence rate of 14.1%
including 24 cases (7.7%) of early epilepsy and 20 cases of advanced epilepsy (6.4%). ② There were significant differences in the EEG patterns between the seizures group and the non-epileptic seizure group (
P
<
0.01). The main EEG pattern was type Ⅲ and type Ⅳ in the seizures group (84.1%)
and type Ⅱ in the non-epileptic seizure group (79.5%). The proportion of types Ⅲ
Ⅳ and Ⅴ was significantly higher in the seizures group (95.5%) than the non-epileptic seizure group (19.0%). ③ There were significant differences in the EEG patterns between the early and late epilepsy groups (
P
<
0.01). Type Ⅲ was the most frequent type in the early epilepsy group (70.8%)
and type Ⅳ was in the late epilepsy group (80.0%).
Conclusion
2
Scalp electroencephalogram has a certain predictive value for secondary epilepsy after aneurysmal subarachnoid hemorrhage. Types Ⅲ
Ⅳ and Ⅴ are high-risk wave types for secondary epilepsy. Types Ⅲ and Ⅳ type may be associated with early and late epilepsy.
关键词
Keywords
references
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