摘要
目的分析额叶癫痫患儿发作期视频脑电图起源部位与临床症状,并进行脑功能预后评价。方法选取2018-05—2020-04唐山市妇幼保健院额叶癫痫患儿140例,均行视频脑电图检查,分析视频脑电图发作起源、发作特点及脑电图起源与发作症状相关性,Logistic回归分析额叶癫痫患儿近期预后影响因素。结果140例额叶癫痫患儿共监测到354次具有明确脑电图起源的临床发作,其中背外侧额部发作155次(43.79%),近中央额部发作148次(41.81%),眶额部发作51次(14.41%);发作症状:偏转性强直219次(61.86%),姿势性强直146次(41.24%),怪异动作133次(37.57%),局部阵挛118次(33.33%),口咽自动症109次(30.79%),发声48次(13.56%),手足自动症39次(11.02%),情绪症状35次(9.89%);偏转性强直、姿势性强直、怪异动作在背外侧额部与近中央额部出现频率高于眶额部,发声、手足自动症在背外侧额部、眶额部出现频率高于近中央额部,情绪症状在眶额部出现频率高于背外侧额部、近中央额部(P<0.05);Logistic回归模型分析显示,病程、发作频繁、脑电图表现均为额叶癫痫患儿近期预后不良影响因素(P<0.05)。结论额叶癫痫患儿发作期视频脑电图定位癫痫源区与临床症状有关,了解额叶解剖部位症状学特征可为临床诊断提供重要参考信息,且视频脑电图表现可一定程度预测患儿脑功能预后,为临床干预提供参考。
Objective To analyze the origin and clinical symptoms of video-EEG during seizures in chil⁃dren with frontal lobe epilepsy,and to evaluate the prognosis of brain function.Methods A total of 140 children with frontal lobe epilepsy in our hospital from May 2018 to April 2020 were selected and underwent video EEG ex⁃amination.The origin and characteristics of video EEG and the correlation between EEG origin and seizure symp⁃toms were analyzed.Logistic regression analysis of short-term prognostic factors in children with frontal lobe epi⁃lepsy.Results A total of 354 clinical seizures with definite EEG origin were monitored in 140 children with fron⁃tal lobe epilepsy,including 155(43.79%)dorsolateral frontal seizures,148(41.81%)near-central frontal sei⁃zures,and 51 seizures(14.41%)orbitofrontal seizures.Seizure symptoms:219(61.86%)deflected rigidity,146(41.24%)postural rigidity,133(37.57%)bizarre movements,118(33.33%)local clonus,oropharyngeal automatism 109 times(30.79%),vocalization 48 times(13.56%),hand-foot automatism 39 times(11.02%),emotional symptoms 35 times(9.89%).The frequency of dorsolateral frontal and near-central frontal areas is higher than that of orbitofrontal areas,the frequency of vocalization and hand-foot automatism in dorsolateral frontal areas and orbitofrontal areas is higher than that of near-central frontal areas,and the frequency of emotional symptoms in the orbitofrontal region is higher than that of the dorsolateral frontal part and the near-central frontal part(P<0.05).Logistic regression model analysis showed that the course of disease,frequent seizures,and EEG manifestations were all influencing factors for the short-term prognosis of children with frontal lobe epilepsy(P<0.05).Conclu⁃sion Video EEG localization of epilepsy source area during seizures in children with frontal lobe epilepsy is related to clinical symptoms.Understanding the symptomatic characteristics of frontal lobe anatomy can provide important reference information for clinical diagnosis,and video EEG performance can predict children to a certain extent.Prognosis of brain function to provide reference for clinical intervention.
作者
刘卿
董琰
韩月明
LIU Qing;DONG Yan;HAN Yueming(Tangshan Maternal and Child Health Hospital,Tangshan 063000,China)
出处
《中国实用神经疾病杂志》
2023年第5期584-589,共6页
Chinese Journal of Practical Nervous Diseases
基金
河北省唐山市2021年医学科学研究课题(编号:20210634)。
关键词
儿童
额叶癫痫
视频脑电图
起源部位
临床症状
脑功能预后
Children
Frontal lobe epilepsy
Video EEG
Origin site
Clinical symptoms
Prognosis of brain function
