儿童癫痫持续状态脑电图特点及脑功能预后

doi:10.3969/j.issn.1000-3606.2020.03.001

临床儿科杂志 ›› 2020, Vol. 38 ›› Issue (3): 161-.doi: 10.3969/j.issn.1000-3606.2020.03.001

• 神经系统疾病专栏 • 下一篇

儿童癫痫持续状态脑电图特点及脑功能预后

靳梅 1，　孙素真 1，　陈玲 1，　程彩云 2，　孙慧 2，　徐梅先 2，　耿文锦 2

河北省儿童医院　1.神经内科，2.重症科（河北石家庄　050000）

发布日期:2020-04-07
通讯作者: 耿文锦　电子信箱：gengwenjin@126.com
基金资助:
河北省省级科技计划（No.182777189）

Electroencephalogram characteristic and brain function prognosis in children with status epilepticus

　JIN Mei1, SUN Suzhen1, CHEN Ling1, CHENG Caiyun2, SUN Hun2, XU Meixian2, GENG Wenjin2

1. Department of Neurology, 2. Department of Pediatric Intensive Care Unit, The Children Hospital of Heibei Province, Shijiazhuang 050000, Hebei, China

Published:2020-04-07

摘要/Abstract

摘要： 　目的　探讨儿童癫痫持续状态（SE）的脑电图特点、脑功能预后及两者的相关性。方法　回顾分析2017年8 月至2018年7月重症监护室（PICU）收治的33例SE患儿的临床资料，将SE患儿分为全面惊厥性癫痫持续状态（GCSE）及非惊厥性癫痫持续状态（NCSE）；以振幅整合脑电图（aEEG）以及小儿大脑及整体表现分类量表（PCOPCS）评估两组患儿的脑功能预后，并分析两者相关性。结果　33例SE患儿中，男17例、女16例，年龄1个月~12岁，GCSE21例、NCSE12例；两组性别、年龄、影像学检查异常率及合并症发生率差异均无统计学意义（P>0.05）。NCSE组咪达唑仑使用时间及入住 ICU时间比GCSE组长，差异均有统计学意义（P<0.05）。GCSE组脑功能预后良好11例，预后不良5例，严重预后不良5例（死亡5例）；NCSE组预后不良5例，严重预后不良7例（死亡5例）。NCSE组脑功能预后差于GCSE组，差异有统计学意义（P<0.05）。根据aEEG中原始脑电图进行分级， 1级10例， 2、 3、 4级各1例， 5级15例， 6级5例。脑电图分级与脑功能近期预后呈显著正相关（r=0.78， P<0.001），即脑电图分级越高，脑功能预后越差。结论　儿童GCSE及NCSE的脑功能预后不同，长程脑电图监测对SE患儿脑功能预后评价具有重要意义。

关键词: 全面惊厥性癫痫持续状态；　非惊厥性癫痫持续状态；　脑电图；　脑功能预后；　儿童

Abstract: 　Objective　To explore the characteristics of electroencephalogram (EEG), the prognosis of brain function and the correlation between them. Methods　The clinical data of status epilepticus (SE) in 33 children treated in pediatric intensive care unit (PICU) from August 2017 to July 2018 were analyzed retrospectively. The children with SE were divided into generalized convulsive status epilepticus (GCSE) and non-convulsive status epilepticus (NCSE). The prognosis of brain function was evaluated by amplitude integrated electroencephalogram (aEEG) and pediatric cerebral and overall performance category scale (PCOPCS), and the correlation between them was analyzed. Results　In the 33 SE children (17 boys, 16 girls) aged from 1 month to 12 years, there were 21 cases of GCSE and 12 cases of NCSE. There were no statistically significant differences in gender, age, abnormal rate of imaging examination and incidence of complications between the two groups (P>0.05). The midazolam use and ICU stay in NCSE group were longer than those in the GCSE group (P<0.05). The GCSE group had a good prognosis of brain function in 11 cases, a poor prognosis in 5 cases, and a severe poor prognosis in 5 cases (5 deaths). In the NCSE group, there were 5 patients with poor prognosis and 7 patients with severe prognosis (5 deaths). According to the original EEG in aEEG, 10 children were classified as grade 1, 1 child as grade 2, 1 child as grade 3, and 1 child as grade 4, 15 children as grade 5, and 5 children as grade 6. There was a significant positive correlation between EEG grade and short-term prognosis of brain function (r=0.78, P<0.001), that is, the higher EEG grade had the worse prognosis of brain function. Conclusion　The prognosis of GCSE and NCSE in children is different. The long-term EEG monitoring is of great significance to the prognosis of SE.

Key words: generalized convulsive status epilepticus;　non-convulsive status epilepticus;　electroencephalogram;　 brain function prognosis;　child

靳梅，孙素真，陈玲，等. 儿童癫痫持续状态脑电图特点及脑功能预后[J]. 临床儿科杂志, 2020, 38(3): 161-.

JIN Mei, SUN Suzhen, CHEN Ling, et al. Electroencephalogram characteristic and brain function prognosis in children with status epilepticus[J]. Journal of Clinical Pediatrics, 2020, 38(3): 161-.

儿童癫痫持续状态脑电图特点及脑功能预后

Electroencephalogram characteristic and brain function prognosis in children with status epilepticus

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