视频脑电图对儿童非癫癎性发作疾病的诊断价值

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【目的】探讨视频脑电图(video electroencephalography,VEEG)监测对儿童非癫癎性发作疾病(video electroencephalography,NES)的诊断价值。【方法】本院儿科视频脑电图室于2009年9月-2011年2月期间,对来280例拟诊或需排除癫病患儿进行了视频脑电图监测,结合视频脑电图监测结果、临床症状、体征、头颅CT、血液生化检查(包括血糖、血氨、心肌酶谱)等病史特点得到NES确定诊断,分析VEEG检查对儿童NES的诊断价值。【结果】75例(26.79%)判定为非癫癎性发作,非癫癎性发作类型包括:心因性NES为13例(17.3%):癔病样发作6例(8.0%),情绪障碍5例(6.7%),屏气发作2例(2.6%)。躯体性NES为62例(82.7%):非癫癎性强直发作16例(21.3%);睡眠障碍11例(14.7%);良性肌阵挛10例(13.3%);头痛7例(9.3%);抽动症6例(8.0%);轻度胃肠炎伴发婴幼儿良性惊厥4例(5.3%);头晕4例(5.3%);良性非癫癎性婴儿痉挛3例(4.0%);脑瘫及运动发育迟缓肌张力增高导致异常动作1例(1.3%)。【结论】视频脑电图对诊断与鉴别诊断非癫癎性发作有重要临床意义。 【Objective】 To investigate the diagnostic value of video electroencephalography (VEEG) in the diagnosis of non-epileptic seizures (NES) in children. 【Methods】 During the period from September 2009 to February 2011, 280 pediatric patients with suspected epilepsy were enrolled in our pediatric video EEG room. Video EEG monitoring was performed. Video EEG monitoring Results The clinical features, head CT, blood biochemical tests (including blood glucose, blood ammonia, myocardial enzymes) and other medical history were confirmed by NES, and the diagnostic value of VEEG in children with NES was analyzed. 【Results】 Seventy-five cases (26.79%) were judged as non-epileptic seizures. Non-epileptic seizure types included 13 cases (17.3%) of cardiogenic NES: 6 cases (8.0% Cases (6.7%), breath-hold attack in 2 cases (2.6%). Sixty-two cases (82.7%) had somatic NES: 16 cases (21.3%) with non-epileptic tonic seizures, 11 cases (14.7%) with sleep disorders, 10 cases with benign myoclonus (13.3%), 7 cases (9.3% ); Tic disorder in 6 cases (8.0%); mild gastroenteritis associated with infant benign convulsions in 4 cases (5.3%); dizziness in 4 cases (5.3%); benign non-epileptic infantile spasms in 3 cases ; Cerebral palsy and motor retardation caused by abnormal muscle tension increased in 1 case (1.3%). [Conclusion] Video EEG has important clinical significance in the diagnosis and differential diagnosis of non-epileptic seizures.
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