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目的探讨老年癫痫视频脑电图的特点。方法选取2013年6月-2014年7月期间接受视频脑电图监测的年龄>16岁的癫痫患者为研究对象。将57例老年癫痫患者(老年组,≥60岁)和65例非老年成人癫痫患者(对照组,16~59岁)进行视频脑电图监测,要求监测的24 h必须经历清醒期及自然睡眠期,并行过度换气试验。比较两组发作间期癫痫样放电检出率、过度换气时异常反应率及分析发作期的脑电图特点。结果 1发作期两组均有以下波形:广泛性低幅快波[(老年组2例(7.4%),对照组4例(12.5%)]、局部性低幅快波[老年组5例(18.5%),对照组6例(18.8%)]、广泛性棘波或棘慢复合波[(老年组3例(11.1%),对照组7例(21.8%)]、局部性棘波或棘慢复合波[(老年组5例(14.9%),对照组8例(25.0%)]、局灶性节律性慢波[(老年组6例(18.5%),对照组6例(18.8%)]。其中老年组出现了:仅有背景活动异常5例(18.5%)、既无背景活动异常也无癫痫样放电1例(3.7%)两种表现。发作期老年组的局灶性癫痫样放电[16例(59.3%)]多于对照组[8例(25.0%)],两组比较差异有统计学意义(P<0.05)。2发作间期老年组的癫痫样放电检出率(清醒期15.8%,睡眠期52.6%)低于对照组(清醒期46.2%,睡眠期83.1%),差异有统计学意义(P<0.05),且可见局灶性慢波(颞区间断节律性δ活动9例)。3自然睡眠中老年组癫痫样放电出现率增多(65.3%)。4老年组的过度换气异常反应出现率(14.0%)低于对照组(64.6%),两组比较差异有统计学意义(P<0.05)。结论老年癫痫发作起始期脑电表现与非老年成人类似,但有以下2种特殊情况:1仅有背景活动异常;2既无背景活动异常,也无癫痫样放电。老年人发作期脑电波为局灶性起始的更多。自然睡眠中老年人癫痫样放电出现率增多。老年人过度换气的异常反应不敏感。
Objective To investigate the characteristics of elderly epilepsy video EEG. Methods Patients with epilepsy aged> 16 years who were monitored by video-EEG during the period from June 2013 to July 2014 were selected as the study objects. Fifty-seven patients with senile epilepsy (aged group, ≥60 years old) and 65 cases of non-elderly adult epilepsy (control group, 16-59 years old) were monitored by video-EEG and required 24 hours of monitoring to experience awake and natural sleep Period, parallel hyperventilation test. The detection rate of epileptiform discharge, the abnormal reaction rate during hyperventilation and the characteristics of electroencephalogram (EEG) were compared between the two groups. RESULTS: All of the two groups had the following waveforms in the attack stage: extensive low-amplitude fast wave [2 (7.4%) in the elderly group and 4 (12.5%) in the control group) 18.5% in the control group, 6 cases in the control group (18.8%)], extensive spikes or spiculation complex waves (11.1% in the elderly group and 7.8% in the control group (21.8% Slow complex waves (5 (14.9%) in the elderly group and 8 (25.0%) in the control group), focal slow rhythm waves (6 in the elderly group (18.5%) and 6 in the control group (18.8% There were 5 cases (18.5%) with abnormal background activity in the elderly group, there was neither abnormal background activity nor 1 case (3.7%) with epileptiform discharges.The incidence of focal epileptiform (P <0.05) .2 The detection rate of epileptiform discharge in the elderly group (2 cases) was higher than that in the control group [8 cases (25.0% 15.8% in awake period and 52.6% in sleep stage) were lower than those in control group (46.2% in awake period and 83.1% in sleep period), and the difference was statistically significant (P <0.05) δ activity in 9 cases) .3 The incidence of epileptiform discharge in the middle-aged and elderly patients increased significantly (65.3%) .4 The abnormal hyperventilation in the elderly group (14.0%) was lower than that of the control group (64.6%), the difference between the two groups was statistically significant (P0.05) .Conclusion The EEG at the beginning of seizure in the elderly is similar to that of the non-elderly adults, but there are two special Case 1: Background abnormalities only 1 Absence of background abnormalities or epileptiform discharges 2) Epileptiform discharges were more frequent in spontaneous sleep in older adults. The abnormal reaction of hyperventilation in the elderly is not sensitive.