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目的:分析脑梗死继发癫痫的EEG诊断价值。方法:回顾性分析我院2012年7-2015年7月收治的60例脑梗死继发癫痫患者临床资料,本组患者均行EEG进行监测,观察并分析其EEG变化情况。结果:根据脑梗死继发癫痫发作时间分为迟发性发作(起病超过2w)与早期发作(起病少于2w);其中迟发性发作共26例,EEG检查出现异样共22例,7例EEG存在尖慢复合波与棘慢复合波,3例EEG慢活动增多;其余34例为早期发作,首发症状3例,患者全身或局部抽动;EEG异常25例,脑电波频率降低至7-8Hz,并表现处弥慢性慢活动,病侧出现局部慢波灶,6例伴有尖慢与棘慢复合波。迟发性发作异常检出率84.61%,早期发作异常检出率73.53%,两者比较差异具统计学意义(P<0.05);脑叶梗死异常检出率为89.19%,显著高于基底节区梗死、多发性梗死及腔隙性梗死异常检出率62.50%、62.50%、50.00%,差异均具统计学意义(P<0.05);脑叶梗死有痫样放电检出率56.76%最高,且显著高于其他部位有痫样放电检出率(P<0.05)。结论:EEG对脑梗死继发癫痫的诊断与癫痫灶的定位具有临床实际应用价值。
Objective: To analyze the diagnostic value of EEG in the diagnosis of secondary epilepsy after cerebral infarction. Methods: The clinical data of 60 patients with epilepsy secondary to cerebral infarction admitted from July 2012 to July 2015 in our hospital were retrospectively analyzed. The patients underwent EEG monitoring and the changes of their EEG were observed and analyzed. Results: According to the time of epileptic seizures after cerebral infarction, it was divided into delayed onset (more than 2w) and early onset (less than 2w); among them 26 were delayed seizures, 22 were abnormal by EEG, Seven cases of EEG had sharp-slow complex wave and slow spin-echo complex, three cases of EEG increased activity; the remaining 34 cases of early attack, the first symptom in 3 cases, patients with systemic or local twitching; EEG abnormalities in 25 cases, brain wave frequency decreased to 7 -8Hz, and slow at the performance of diffuse chronic activity, the disease appeared local slow wave stove, 6 patients with slow and slow spike complex wave. The detection rate of delayed onset seizure was 84.61%, the rate of early seizure abnormality was 73.53%, the difference was statistically significant (P <0.05); the abnormal rate of cerebral infarction was 89.19%, which was significantly higher than basal ganglia The detection rates of regional infarction, multiple infarction and lacunar infarction were 62.50%, 62.50% and 50.00%, respectively, with statistical significance (P <0.05). The detection rate of epileptiform discharge in cerebral infarction was 56.76% And was significantly higher than other parts of the detection rate of epileptiform discharge (P <0.05). Conclusion: EEG has clinical value in the diagnosis of epilepsy secondary to cerebral infarction and the localization of epileptic foci.