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目的:分析手足口病并发病毒性脑炎的脑电图特点及探究脑电图在该病的诊断中的临床应用价值。方法:通过分析2010年7月至2013年8月收治的64例经天台县人民医院临床确诊为手足口病并发病毒性脑炎患儿的临床资料及脑电图资料,探讨患儿的脑电图特点及其与病理基础的相关性。结果:64例患儿行脑电图检查,脑电图检查结果59例异常,异常率92.2%,而颅CT检查结果仅5例异常,异常率为7.8%。脑电图显示结果较准确且及时反映不同时期的手足口病并发病毒性脑炎临床表现。手足口病并发病毒性脑炎临床早期脑电图表现:α波逐渐减少,频率减慢,以θ波为基本节律,由顶、枕部扩展至全脑,呈θ波广泛性慢性节律,患儿30例,占46.9%;中期表现:呈多形性高波幅θ波或混有δ波,有时局限性加重,常可出现发作性或连续性棘波、棘慢波综合等发作波,患儿22例,占34.4%;极期:在广泛低波幅背景上出现爆发性抑制活动,最后可出现平坦活动,临床痉挛发作波的倾向更明显,患儿7例,占10.9%。脑电图复查结果也较明确地反映了治疗后的临床病理改变。结论:脑电图改变的范围以及严重程度能够敏锐地反映中枢病变的范围和脑损伤的程度,是手足口病并发病毒性脑炎的早期诊断,治疗及预后评估的重要参考指标。
Objective: To analyze the characteristics of electroencephalogram of hand-foot-mouth disease complicated with viral encephalitis and to explore the clinical value of EEG in the diagnosis of the disease. Methods: By analyzing the clinical data and EEG data of 64 cases diagnosed as HFMD complicated with viral encephalitis in Tiantai People’s Hospital from July 2010 to August 2013, the EEG Figure features and their relevance to the pathology. Results: Electroencephalography (EEG) was performed in 64 children. The results of EEG were abnormal in 59 cases (92.2%). However, only 5 cases were abnormal by skull CT, and the abnormal rate was 7.8%. EEG shows that the results are accurate and timely reflect the different stages of hand, foot and mouth disease complicated with clinical manifestations of viral encephalitis. Hand, foot and mouth disease complicated with viral encephalitis Clinical early EEG performance: α wave gradually decreased, the frequency slowed to θ wave as the basic rhythm, from the top, occipital extended to the whole brain, was θ wave broad chronic rhythm, suffering from 30 cases, accounting for 46.9%; mid-term performance: pleomorphic high-amplitude θ-wave or mixed with δ-wave, and sometimes increased limitations, often with episodic or continuous spikes, 22 cases, accounting for 34.4%; polar period: in a wide range of low-amplitude background explosive inhibition occurs, and finally flat activity may occur, clinical seizure wave tendency more pronounced, 7 cases of children, accounting for 10.9%. EEG review results also more clearly reflect the clinical and pathological changes after treatment. Conclusion: The extent and severity of EEG changes can reflect acutely the extent of central lesion and brain injury. It is an important reference for the early diagnosis, treatment and prognosis evaluation of hand, foot and mouth disease complicated with viral encephalitis.