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目的:探讨一氧化碳(Carbon monoxide,CO)中毒继发癫痫的经颅多普勒(Transcranial Doppler,TCD)和脑电图(Electroencephalogram,EEG)特征的关系。方法:对我院自2011年6月至2015年5月收治的145例CO中毒患者的临床资料和EEG、TCD特征进行检查,并分析其与继发癫痫的相关性。结果:145例CO中毒患者中,EEG结果显示正常患者93例(64.13%);异常患者52例(35.86%)。TCD正常患者90例(62.07%),异常55例(37.93%)。主要表现为颈内动脉系统血流动力学的改变,大脑前动脉流速与病情严重程度成正相关,TCD血流速度增加或减慢不对称,脑血流速度升高比率显著高于脑血流速度减低比率。无论在睡眠期还是清醒期EEG异常患者全导阵发性3.0~4.0Hz的棘慢波均存在放电。患者出现EEG、TCD异常与年龄、癫痫家族史、发热温度、持续时间、继发癫痫类型以及24h内发作次数有关。继发癫痫39例,占EEG异常患儿的75.00%,占TCD异常患儿的72.73%。继发癫痫患者中,15例额区放电日后发生发生癫痫14例(93.33%),19例枕区放电16例(84.21%)发生癫痫,13例Rolandic区放电8例(61.54%)发生癫痫,5例广泛性棘慢波者继发癫痫的有1例(20%)。结论:EEG、TCD检查异常的CO中毒患者中具有较高的继发癫痫的发病率,中枕区和额区阵发性异常放电者更容易继发癫痫。
Objective: To investigate the relationship between Transcranial Doppler (TCD) and Electroencephalogram (EEG) features of carbon monoxide (CO) poisoning secondary epilepsy. Methods: The clinical data and EEG, TCD features of 145 patients with CO poisoning admitted to our hospital from June 2011 to May 2015 were examined and their correlations with secondary epilepsy were analyzed. Results: Of the 145 patients with CO poisoning, the results of EEG showed that 93 cases (64.13%) were normal and 52 cases (35.86%) were abnormal. TCD normal patients 90 cases (62.07%), abnormal 55 cases (37.93%). Mainly for the internal carotid artery hemodynamics changes, the anterior cerebral artery flow velocity and the severity of the disease is positively related to TCD blood flow velocity increases or decreases asymmetry, the cerebral blood flow velocity increased significantly higher than the cerebral blood flow velocity Reduce the ratio. No matter in the sleep or awake period, patients with EEG abnormality all-paroxysmal paroxysmal paroxysmal 3.0-4.0Hz wave discharge. Patients with EEG, TCD abnormalities and age, family history of epilepsy, fever temperature, duration, type of secondary epilepsy and 24h episodes related. 39 cases of secondary epilepsy, accounting for 75.00% of children with abnormal EEG, accounting for 72.73% of children with abnormal TCD. In 15 cases of epilepsy, epilepsy occurred in 15 cases of epilepsy (93.33%), in 19 cases of occipital discharge in 16 cases (84.21%), in 13 cases of Rolandic area discharge in 8 cases (61.54%). One patient (20%) had epilepsy secondary to the widespread spike wave. Conclusion: The incidence of secondary epilepsy in patients with CO poisoning abnormalities detected by EEG and TCD is higher. Epilepsy is more likely to occur in patients with paroxysmal anomalies in the medial and occipital regions.