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目的 分析婴儿痉挛的临床发作特征 ,探讨视频脑电图 (Video EEG)检查在诊断中的作用。方法 对 1999年 1月至 2 0 0 3年 10月中国医科大学深圳儿童医院收治的 6 1例婴儿痉挛患儿采用Video EEG监测 ,观察婴儿痉挛发作的临床表现和发作期以及发作间期的脑电图特征。结果 共监测到 87次痉挛发作 ,可见 4种表现类型 ,主要为屈肌型痉挛。发作时脑电图可见 7种形式 ,主要为快波节律或高波幅单个尖慢复合波 (或仅慢波 ) ,后随电压抑制。 13次发作仅出现 1种形式脑电图改变。 74次出现 2种或 2种以上形式的脑电图改变 ,最多可在一次发作中见到 4种形式脑电图改变。发作间期的脑电图背景活动均失去正常结构 ,以典型的高峰节律紊乱和变异型的高峰节律紊乱为主。在同一个患儿的监测中 ,可同时见到多种形式脑电图改变。结论 婴儿痉挛独特的轴性痉挛可表现为多种形式和合并其它形式发作。EEG在发作期和发作间期有多种形式 ,高峰节律紊乱是大多数婴儿痉挛的特征性脑电图形。Video EEG监测可为诊断和鉴别诊断婴儿痉挛提供依据
Objective To analyze the clinical features of infantile spasms and discuss the role of Video EEG in the diagnosis. Methods Sixty infants with infantile spasms admitted from Shenzhen Children’s Hospital of China Medical University from January 1999 to October 2003 were monitored by Video EEG to observe the clinical manifestations and the onset of infantile spasms and the relationship between the brain Electrogram characteristics. Results A total of 87 episodes of spasticity were detected. There were 4 types of manifestations, mainly flexor spasm. Seizures EEG visible in seven forms, mainly fast wave rhythm or high amplitude single sharp slow complex (or only slow wave), followed by voltage suppression. Thirteen episodes showed only one form of EEG changes. 74 times there are two or more forms of EEG changes, up to one attack can see the four forms of EEG changes. EEG interictal background activity loss of normal structure, the typical peak rhythm disorders and mutation-based peak rhythm disorders. In the same child’s monitoring, you can see multiple forms of EEG changes. Conclusions The unique spasticity of infantile spasm can manifest in various forms and in combination with other forms of seizures. There are many forms of EEG during the seizure and seizure. Peak rhythm disorders are characteristic EEG patterns of most infant spasticity. Video EEG monitoring can provide a basis for the diagnosis and differential diagnosis of infantile spasms