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目的:探讨VEEG与头颅MRI在儿童癫痫的诊断中的应用价值,寻找二者之间相互关系,为临床确诊该病提供简便易行的诊断思路。方法:对2007年1月-2009年2月住院的120例惊厥发作儿童进行VEEG监测,并与REEG结果进行对比,同时与MRI影像学检查结果进行对照分析。结果:在120例患者中,VEEG监测到临床发作患者癫痫样放电55例(45.83%),REEG监测到22例(18.33%),VEEG监测阳性率高于REEG(X2=20.82,P<0.01);VEEG监测到发作间期脑电图痫样放电32例(26.7%),REEG监测3例(2.5%),VEEG监阳性率明显高于REEG(X2=28.13,P<0.0);结合临床及影象学结果,VEEG明确癫痫类型20例(16.7%),REEG仅明确3例(2.5%)(X2=15.56,P<0.01);34例MRI与VEEG同时异常的患者,两者的定位相符16例(47.1%),定侧相符13例(38.2%),不相符5例(14.7%)。结论:在检测癫痫患儿临床发作及发作间期脑电图痫性放电中,数字化VEEG检测到的阳性率明显高于REEG。MRI和VEEG结合更有助于癫痫的诊断和定位。
Objective: To explore the value of VEEG and cranial MRI in the diagnosis of children with epilepsy, to find the relationship between the two, and to provide a simple and convenient diagnostic method for the clinical diagnosis of the disease. Methods: VEEG monitoring was performed in 120 children with seizures who were hospitalized from January 2007 to February 2009 and compared with the results of REEG. The results were compared with MRI findings. Results: Among the 120 patients, 55 cases (45.83%) of epileptiform discharges were detected by VEEG, 22 cases (18.33%) were detected by REEG and the positive rate of VEEG was higher than that of REEG (X2 = 20.82, P <0.01) ; VEEG monitored 32 cases (26.7%) of epileptic discharge during interictal period and 3 cases (2.5%) of REEG monitored by VEGEG. The positive rate of VEEG was significantly higher than that of REEG (X2 = 28.13, P <0.0) Imaging results, VEEG clear type of epilepsy in 20 cases (16.7%), REEG only 3 cases were clear (2.5%) (X2 = 15.56, P <0.01); 34 cases of MRI and VEEG simultaneous abnormalities in patients with both positioning 16 cases (47.1%), 13 cases (38.2%) were consistent, 5 cases (14.7%) were not consistent. Conclusion: The detection rate of VEEG by digital VEEG was significantly higher than that of REEG in the detection of seizures and epileptic seizures in children with epilepsy. MRI and VEEG more conducive to the diagnosis and location of epilepsy.