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目的分析新生儿惊厥的发病原因及数字化视频脑电图(VEEG)的特点。方法选择2010年7月至2015年2月我院新生儿病房住院诊断为新生儿惊厥并进行了VEEG检查的患儿为研究对象,回顾性记录患儿临床资料,包括起病日龄、发作形式及VEEG结果,根据病史和辅助检查判断惊厥原因。结果共收录新生儿惊厥48例,均为反复惊厥发作,足月儿占89.6%,生后72 h内起病35例(72.9%),7天内起病占79.2%。病因明确27例(56.2%),病因不明21例(43.8%)。在已明确的病因中以围产期脑损伤(59.3%)为主,其次为先天性脑发育异常(18.5%)和代谢紊乱(14.8%)。发作形式以单一发作为主(37例,占77.1%),发作形式前三位分别为微小型发作、多灶性阵挛型发作和强直型发作;复合发作(表现为两种及以上发作形式)11例(22.9%),以微小型发作伴多灶性阵挛型为主。48例患儿VEEG检查正常1例,异常47例,其中轻度异常18例(38.3%),中度异常21例(44.7%),重度异常8例(17.0%);VEEG以单一异常为主(34例,72.3%),包括阵发性异常17例,成熟性异常12例,背景活动异常5例;复合异常(两种以上异常)13例,以成熟性异常伴阵发性异常为主。48例患儿在做VEEG检查时发现癫疒间性发作15例(31.2%),非癫疒间性发作22例(45.8%),无发作11例(22.9%)。结论新生儿惊厥多发生在生后1周之内,以围产期脑损伤为主要病因,VEEG多为轻中度异常。VEEG检查有助于鉴别新生儿惊厥和非惊厥性发作。
Objective To analyze the causes of neonate eclampsia and the characteristics of digital video electroencephalogram (VEEG). Methods From July 2010 to February 2015, our hospital neonatal ward diagnosed as neonatal convulsions and VEEG examination of children as the research object, retrospectively record the clinical data of children, including onset age, onset form And VEEG results, according to medical history and laboratory tests to determine the causes of seizures. Results A total of 48 cases of neonatal seizures were recorded, all of which were recurrent seizures. The full-term children accounted for 89.6%, 35 cases (72.9%) within 72 hours after birth, and 79.2% within 7 days. Etiology was clear in 27 cases (56.2%), etiology in 21 cases (43.8%). Perinatal brain injury (59.3%) was the predominant cause, followed by congenital brain dysplasia (18.5%) and metabolic disorders (14.8%). The main attack pattern was single attack (37 cases, 77.1%). The first three attack patterns were microsection, multifocal clonus and tonic attack respectively. Combined attack (manifested as two or more attack forms ) (N = 11) (22.9%), with microthrombotic polyfocal clonus. Among the 48 cases, 1 case had normal VEEG and 47 cases had abnormal VEEG, of which 18 cases were mild abnormality (38.3%), 21 cases were moderate abnormality (44.7%) and 8 cases were severe abnormality (17.0%). VEEG was mainly single abnormal (34 cases, 72.3%), including 17 cases of paroxysmal anomalies, 12 cases of mature abnormalities and 5 cases of abnormal background activity. 13 cases had complex abnormalities (more than two kinds of abnormalities) . Fifty-eight patients (31.2%) had seizures, 22 (45.8%) had non-seizures, and 11 (22.9%) had seizures during the VEEG examination. Conclusions Neonatal convulsions occur mostly within 1 week after birth. Perinatal brain injury is the main cause. VEEG is mostly mild to moderate abnormality. VEEG examination can help identify neonatal convulsions and non-convulsive seizures.