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目的癫癎发作及癫癎样放电具有昼夜倾向,睡眠是诱发癫癎的重要因素之一,但睡眠触发癫癎的易感性在不同的睡眠时相对发作及发作间期癫癎样放电的影响并不相同。该文主要研究局灶性及全面性癫癎儿童发作间期睡眠和觉醒状态癫癎样放电的特点。方法采用24h动态脑电图、多导睡眠脑电图及长程视频脑电图仪描记48例原发性癫癎儿童的全夜睡眠(至少一个完整的睡眠周期)和睡眠前后觉醒状态的脑电资料,统计分析觉醒期及各睡眠期棘/尖波、棘/尖慢波等癫癎样波的放电指数的差异,比较局灶性和全面性发作类型癫癎儿童癫癎样放电阳性率的差异。结果局灶性癫癎儿童组发作间期脑电图癫癎样放电的阳性率高于全面性癫癎儿童组(16/25,64.0%)vs(9/25,36.0%),(P<0.05)。癫癎患儿非快速动眼睡眠各期(S1～S4)癫癎样波放电指数为21.13±19.96,19.59±17.76,22.85±18.99,20.37±16.63,均高于觉醒期的8.20±6.21(P<0.05)。非快速动眼睡眠期S3期癫癎样波放电指数明显高于快速动眼睡眠期(22.85±18.99vs12.91±10.95),(P<0.05)。结论局灶性癫癎儿童发作间期脑电图癫癎样放电的阳性率较全面性癫癎儿童癫癎样放电阳性率高。睡眠,尤其是非快速动眼睡眠期对癫癎儿童癫癎样放电具有易化作用。
The purpose of epileptic seizures and epileptiform discharges have a diurnal tendency, sleep is one of the important factors inducing epilepsy, but sleep-triggered epilepsy susceptibility in different sleep relative seizures and interictal epileptiform discharges Are not the same. This paper focuses on the characteristics of epileptiform discharges in sleep and wakefulness in children with focal and complete epilepsy. Methods EEG, polysomnography and long-term video electroencephalography were used to record the changes of nighttime sleep (at least one full sleep cycle) and wakefulness of EEG in 48 cases of primary epileptic children Data, statistical analysis of the awakened and sleep-onset spikes / spikes, spikes / sharp waves and other epileptiform samples of the discharge index differences, compared focal and comprehensive seizure-type epileptic children with epileptiform discharge-positive rate difference. Results The positive rate of epileptiform discharge in interictal epileptic children was significantly higher than that in children with generalized epilepsy (16 / 25,64.0% vs 9/25, 36.0%, P < 0.05). The epileptiform discharge index was 21.13 ± 19.96, 19.59 ± 17.76, 22.85 ± 18.99 and 20.37 ± 16.63 in the non-rapid eye movement sleep stage (S1 ~ S4) of epilepsy children, which were all higher than that of awake period of 8.20 ± 6.21 (P <0.05). The non-fast eye movement sleep phase S3 epileptiform discharge index was significantly higher than the fast eye movement sleep (22.85 ± 18.99vs12.91 ± 10.95), (P <0.05). Conclusion The positive rate of epileptiform discharge in children with focal epilepsy is higher than that in children with generalized epilepsy. Sleep, especially non-rapid eye movement sleepy epileptic children epileptiform discharge with ease.