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目的研究夜发性额叶癫痫的临床症状和睡眠录像脑电图(VEEG)特征及其与睡眠分期的相关性。方法纳入2008年1月至2009年6月在我院接受24 h脑电图录像监测的夜发性额叶癫痫患者30例,对监测期间睡眠中的110次发作进行研究,其发作特点和脑电图特征分别由有经验的临床医师和脑电图医师进行分析。结果夜发性额叶癫痫按其发作时不同的运动特征、发作持续时间及发作强度分类,其常见的发作形式为夜间阵发肌张力障碍、阵发性觉醒,常见症状依次为:不对称性姿势强直、睁眼凝视、躯体运动自动症、头眼偏转、怪异表情,95%在非快速眼动睡眠(NREM)期发作,其中NREMⅠ、Ⅱ期占73%。53%发作间期睡眠脑电图有痫性放电,其中NREMⅡ期47%。结论夜发性额叶癫痫并不少见,正确认识其发作时的临床症状和睡眠脑电图特征及其与睡眠周期的相关性,通过24 h录像脑电监测,有助于额叶癫痫的诊断及与各种睡眠相关性疾病鉴别,并指导临床治疗。
Objective To study the clinical features of sleep deprived frontal lobe epilepsy and sleep recording EEG (VEEG) characteristics and its relationship with sleep stage. Methods Thirty patients with nocturnal frontal lobe epilepsy undergoing 24-hour EEG recording monitoring in our hospital from January 2008 to June 2009 were included in this study. 110 episodes of sleep during the monitoring period were studied. The electrogram features were analyzed by experienced clinicians and EEG physicians, respectively. Results nocturnal frontal lobe epilepsy according to their attack different motor characteristics, duration of seizures and seizures intensity classification, the common form of seizures nighttime dystonia, paroxysmal arousals, the common symptoms were: asymmetry Postural rigidity, eyes open and staring, somatic autonomic disorders, head-eye deflections, weird facial expressions, 95% in non-REM sleep episodes, of which 73% of NREM Ⅰ, Ⅱ period. Epileptic seizures occurred in 53% of interictal sleep EEGs, of which 47% were in NREM II. Conclusions Nocturnal frontal lobe epilepsy is not uncommon. Correct understanding of the clinical symptoms and the characteristics of sleep EEG and its relationship with sleep cycle at the onset of stroke can be helpful for the diagnosis of frontal lobe epilepsy And with a variety of sleep-related diseases identification, and guide clinical treatment.