目的:探讨伴有缺口节律的癫痫患者的临床和脑电图特点，以提高临床对缺口节律的认识，避免过度解读。方法:回顾性收集2016年1月至2017年1月于空军军医大学西京医院神经内科脑电监测中心就诊的伴有缺口节律的12例癫痫患者。对其临床资料，包括病因、临床表现、脑电图特征及预后进行总结，并采用门诊复诊及电话随访，随访时间至少3年。结果:最终收集12例缺口节律癫痫患者的临床资料，其中男性8例，女性4例，年龄36~78岁。经分析发现脑外伤是缺口节律最常见的原因，其中颅骨缺损未修补2例，颅骨钛网修补8例，颅骨聚甲基丙烯酸甲酯修补1例，颅骨聚醚醚酮修补1例。12例患者缺口节律的分布与颅骨异常区一致。缺口节律的脑波既可以表现为高波幅、快频率，也可以表现为低波幅、慢频率。缺口节律可以单个出现（类似尖波、棘波）。10例患者在多形性慢波的基础上夹杂尖波、棘波发放，影像学证实其合并相应部位的脑组织损伤。12例患者均有癫痫发作史，以强直阵挛发作和（或）局灶性发作最为常见。3例有缺口节律的患者临床无癫痫发作5年以上，既往因脑电监测提示有癫痫性棘波，一直服用抗癫痫药物治疗，脑电监测后给予减停药，随访3年无发作。结论:颅骨修补是缺口节律的常见原因，不同电阻的修补材料导致缺口节律的波形和频率也不相同。缺口节律、癫痫样放电及其他病理性慢波活动可以同时存在，缺口节律为良性变异，无需特殊治疗。“,”Objective:To investigate the clinical characteristics and electroencephalogram (EEG) of epilepsy patients with breach rhythm, improve clinical understanding of breach rhythm and avoid over-interpretation.Methods:Twelve epilepsy patients with breach rhythm who visited the Department of Neurology, Xijing Hospital, the Air Force Military Medical University from January 2016 to January 2017 were collected retrospectively. The clinical data, including etiology, clinical manifestations, EEG features and prognosis were summarized, and outpatient and telephone follow-up was performed for at least three years.Results:The clinical data of 12 patients with epilepsy with breach rhythm were collected, including eight males and four females, aged 36-78 years. After analysis, it was found that brain trauma was the most common cause of breach rhythm. Among them, two cases of skull defect were not repaired, eight cases were repaired with skull titanium mesh, one case was repaired with skull polymethylmethacrylate, and one case was repaired with skull polyetheretherketone. The distribution of the breach rhythm in 12 patients was consistent with the abnormal area of the skull. The breach rhythm can be expressed as high amplitude and fast frequency, or low amplitude and slow frequency and appear individually (similar to sharp waves, spikes). On the basis of pleomorphic slow waves, 10 patients were mixed with sharp waves and spike waves, and imaging confirmed that they had brain damage in corresponding parts. All of the 12 patients had a history of seizures, with tonic-clonic seizures and (or) focal seizures being the most common. Three patients with breach rhythm had no clinical seizures for more than five years, and had been taking antiepileptic drugs for epileptic spikes on EEG, and they were given reduction and discontinuation of the drugs and were seizure-free for three years during follow up.Conclusions:Skull repair is a common cause of breach rhythm, and repair materials with different resistances cause different waveforms and frequencies. Breach rhythm, epileptiform discharge and other pathological slow-wave activities can exist at the same time. Breach rhythm is a benign variant phenomenon which needs no special treatment.