北京大学学报（医学版）2018，Vol.50Issue(2)：213-220,8.DOI:10.3969/j.issn.1671-167X.2018.02.003
头皮脑电图中高频振荡在癫痫性脑病伴睡眠中持续棘慢波患儿中的应用
Application of scalp-recorded high-frequency oscillations in epileptic encephalopathy with continuous spike-and-wave during sleep
摘要
Abstract
Objective:To investigate the clinical significance of high-frequency oscillations (HFOs) on scalp electroencephalography (EEG) in patients with epileptic encephalopathy with continuous spikeand-wave during sleep (CSWS).Methods:Twenty-one CSWS patients treated for epilepsy from January 2006 to December 2016 in Pediatric Department of Peking University First Hospital were enrolled into the study.Selected clinical variables including gender,age parameters,seizure frequencies and antiepileptic drugs were compared between (a).HFO-positive group and HFO-negative group before methylprednisolone treatment and (b).excellent seizure outcome group and not-excellent seizure outcome group after methylprednisolone treatment.Interictal HFOs and spikes in pre-and post-methylprednisolone scalp EEG were measured and analyzed.Results:Before methylprednisolone treatment,there were 12 of 21 (57％) CSWS patients had HFOs,with a mean value 43.17 per 60 s per patient.The 12 patients with HFOs tended to have more frequent epileptic negative myoclonus/atonic/myoclonus/atypical absences than those without HFOs in a month before methylprednisolone treatment.A total of 518 HFOs and 22 592 spikes were found in the pre-methylprednisolone EEG data of 21 patients,and 441 HFOs (86％)were associa-ted with spikes.The highest amplitudes of HFOs were significantly positively correlated with that of spikes (r =0.279,P ＜ 0.001).Rates reduced by methylprednisolone treatment were statistically significant for both HFOs (P =0.002) and spikes (P =0.006).The percentage of reduction was 91％ (473/518) and 39％ (8 905/22 592) for spikes and HFOs,respectively.The percentage of spike and HFOs changes was respectively 100％ decrease and 47％ decrease in the excellent seizure outcome group,and they were 79％ decrease and 18％ increase in the not-excellent seizure outcome group.Conclusion:Prevalence of HFOs might reflect some aspect of epileptic activity.HFOs were more sensitive to methylprednisolone treatment than spikes and had a good correlation with the prognosis of seizures,and HFOs could be applied to assess epilepsy severity and antiepileptic therapy.关键词
高频振荡/癫痫性脑病伴睡眠中持续棘慢波/头皮脑电图/时频分析Key words
High-frequency oscillations/Epileptic encephalopathy with continuous spike-and-wave during sleep/Scalp electroencephalography/Time-frequency analysis分类
医药卫生引用本文复制引用
龚潘,杨志仙,薛姣,钱萍,杨海坡,刘晓燕,边凯归..头皮脑电图中高频振荡在癫痫性脑病伴睡眠中持续棘慢波患儿中的应用[J].北京大学学报（医学版）,2018,50(2):213-220,8.基金项目
北京大学医学-信息科学交叉学科种子基金(BMU20160586)、北京市科学技术委员会(Z171100001017125)及国家自然科学基金(81771393)资助 Supported by Peking University Seed Fund for Medicine-Information Interdisciplinary Research Project(BMU20160586),Beijing Municipal Science&Technology Commission (Z171100001017125) and National Science Foundation of China (81771393) （BMU20160586）
