CAJ | 학술논문

目的探讨如何对疑似癫(癎)发作但在发作过程中无明确癫(癎)样放电(棘波、尖波、棘慢波、尖慢波)的病例进行明确诊断.方法对36例临床上疑似癫痫发作,但常规脑电图和影像学检查(包括头颅cT及MRI)均未见异常的患者做24 h视频脑电图(VEEG)监测.结果 36例患者中30例24 h VEEG记录到至少1次发作,6例无发作.间歇期记录到典型癫瘸样放电20例(尖波、棘波、尖慢波、棘慢波),有不典型异常脑电改变者5例(慢波或电压改变).全部患者中26例(72.2%)诊断为癫痫,3例(8.3%)诊为晕厥,2例(5.6%)诊为假性发作,2例(5.6%)诊为儿童抽动秽语综合征,3例(8.3%)不能明确.结论针对疑似癫痢样发作但发作过程中无明确癫痼样放电的病例,可以通过做24 h VEEG结合间歇期脑电特点、视频记录到的临床表现、脑电图的参数调节和病史帮助明确诊断.
목적 탐토여하대의사전(간)발작단재발작과정중무명학전(간)양방전(극파、첨파、극만파、첨만파)적병례진행명학진단.방법 대36례림상상의사전간발작,단상규뇌전도화영상학검사(포괄두로cT급MRI)균미견이상적환자주24 h시빈뇌전도(VEEG)감측.결과 36례환자중30례24 h VEEG기록도지소1차발작,6례무발작.간헐기기록도전형전가양방전20례(첨파、극파、첨만파、극만파),유불전형이상뇌전개변자5례(만파혹전압개변).전부환자중26례(72.2%)진단위전간,3례(8.3%)진위훈궐,2례(5.6%)진위가성발작,2례(5.6%)진위인동추동예어종합정,3례(8.3%)불능명학.결론 침대의사전리양발작단발작과정중무명학전고양방전적병례,가이통과주24 h VEEG결합간헐기뇌전특점、시빈기록도적림상표현、뇌전도적삼수조절화병사방조명학진단.
Objective To explore the diagnosis of patients who suffered from epileptiform attack without epileptic waves(sharp wave,spike wave,sharp-slow complex wave,spike-slow complex wave)in electroenchaphlogram (EEG)during attack.Methods The monitoring of 24 hours video-electroencephalography(VEEG)with a heart electrode were performed in 36 patients who had epileptiform attack but regular EEG and CT or MRI for brain were normal.Results Totally 26 patients were diagnosed of epilepsy,3 patients were diagnosed of syncope,2 patients were diagnosed of false epileptic attack and 2 patients were diagnosed of tic disorders.3 patients had no confirmed diagonisis. Conclusion The monitoring of 24 hours video-electroencephalography(VEEG)with a heart electrode,EEG,VEEG,detailed history and electroencephalography can be helpful to make a diagnosis of patients who have epileptiform attack without epileptic waves.