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目的探讨各年龄段小儿惊厥常见病因及惊厥发作时视频脑电图特点,为临床诊断及治疗提供参考。方法选取2015年3月~2016年3月期间我院收治的407例惊厥患儿为研究对象,分析小儿惊厥常见原因,对其进行视频脑电图监测,比较脑电图监测时间与性别、年龄、发作持续时间、发作次数的关系。结果 407例惊厥患儿中,热性惊厥占37.10%,癫痫占29.73%,颅内感染占10.07%;不同年龄组小儿惊厥原因不同,其中新生儿期以缺血缺氧性脑病最多见,婴幼儿以高热惊厥最多见,年长儿以癫痫最多见。所有患儿均进行了发作间期视频脑电图监测,正常191例(48.48%),异常216例(51.60%),脑电图异常与惊厥发作持续时间、发作次数有密切关系,提示发作持续时间越长,发作越频繁,脑电图异常率越高,差异均具有统计学意义(P<0.05)。视频脑电图监测时长分别为0.5h(25.00%),1h(40.91%),2h(78.82%),12h(100%),监测时间越长,视频脑电图阳性率越高,差异具有统计学意义(P<0.05);0.5h组与2h,12h组比较,差异具有统计学意义(P<0.05),1h组与2h,12h组间差异具有统计学意义(P<0.05),其余各组间比较,差异均无统计学意义(P>0.05)。结论新生儿惊厥以缺血缺氧性脑病多见,婴幼儿多发高热惊厥,年长儿则以癫痫为主;视频脑电图监测对小儿惊厥诊断具有重要意义,其中2h监测阳性率78.82%,患儿及家长依从性好,临床应用价值高。
Objective To investigate the common causes of convulsions in children of all ages and the features of video-EEG in seizures, and to provide references for clinical diagnosis and treatment. Methods A total of 407 patients with convulsion admitted to our hospital from March 2015 to March 2016 were selected as subjects. The common causes of convulsions in children were analyzed. Video EEG monitoring was performed. EEG monitoring time, sex, age , The duration of the attack, the number of seizures. Results In 407 children with convulsion, the febrile seizures accounted for 37.10%, epilepsy accounted for 29.73% and intracranial infections accounted for 10.07%. There were different causes of seizures in different age groups, of which hypoxic-ischemic encephalopathy was the most common in infancy, Infants with febrile seizures most common, older children with epilepsy most common. All children underwent interictal video-EEG monitoring. There were 191 normal cases (48.48%) and 216 abnormal cases (51.60%). EEG abnormality was closely related to the duration of seizures and the number of seizures, suggesting that seizures continued The longer the time, the more frequently the attack, the higher the abnormal rate of EEG, the differences were statistically significant (P <0.05). The duration of video EEG monitoring was 0.5h (25.00%), 1h (40.91%), 2h (78.82%) and 12h (100%) respectively. The longer the monitoring time, the higher the positive rate of video EEG. (P <0.05). The difference between 0.5h group and 2h, 12h group was statistically significant (P <0.05). The difference between 1h group and 2h, 12h group was statistically significant (P <0.05) There was no significant difference between the two groups (P> 0.05). Conclusions Neonatal convulsions are more common in hypoxic-ischemic encephalopathy. Infants and young children have multiple febrile seizures and older children are mainly epilepsy. Video EEG monitoring is of great significance in the diagnosis of convulsions in children. The positive rate of 2-h monitoring is 78.82% Children and parents have good compliance and high clinical value.