儿童失神癫痫临床与功能磁共振研究

发布时间：2018-04-30 22:09

本文选题：儿童失神癫痫 + 诊断标准　；参考：《南京大学》2012年硕士论文

【摘要】：第一部分儿童失神癫痫2种诊断标准的临床研究目的儿童失神癫痫(Childhood absence epilepsy, CAE)是儿童期起病癫痫最常见类型之一,目前临床工作对该病的诊断中存在2种诊断标准,即国际抗癫痫联盟于1989年及2005年分别提出的“儿童失神癫痫诊断标准”。本文根据我院就诊癫痫患者临床资料探讨国际抗癫痫联盟儿童失神癫痫两种诊断标准的临床意义。方法本研究对我院就诊癫痫患者分别依据两种诊断标准确诊为儿童失神癫痫的两组患者进行临床特征及脑电图特征的比较。结果发作时程2005年标准诊断的患者较长,脑电图诱发试验阳性率1989年标准诊断的患者较高,发作多药(三药)控制率1989年标准诊断的患者中比例较高。结论国际抗癫痫联盟2005年诊断标准更能保证诊断患者的同质性,发作易于控制。第二部分儿童失神癫痫血氧依赖性功能磁共振研究目的探讨儿童失神癫痫发作期各脑区代谢变化。方法应用EEG-fMRI扫描发作期与发作间期BOLD信号,并应用广义线性模型发现脑区激活与抑制改变。结果共有16例患者于EEG-fMRI扫描期间出现电-临床发作36次,3Hz棘慢波放电期间fMRI信号增高出现于丘脑、额叶皮层、初级视觉区、听觉区、运动皮层；fMRI降低出现于顶叶、扣带回及基底节区。结论丘脑与额叶皮层是参与失神癫痫病理生理机制的重要结构。
[Abstract]:Part I Clinical study of two diagnostic criteria for children with aphasia Objective Childhood absence epilepsy (CAEE) is one of the most common types of epilepsy in childhood, and there are two diagnostic criteria in clinical work. In 1989 and 2005, the International Anti-Epilepsy Federation put forward the Diagnostic criteria of Childhood Aphasia Epilepsy. Based on the clinical data of epileptic patients in our hospital, the clinical significance of two diagnostic criteria for children with aphasia in the International Anti-Epilepsy League (IAEU) was discussed. Methods the clinical and EEG features of two groups of epilepsy patients diagnosed as children with aphasia according to two diagnostic criteria were compared. Results the duration of seizure in 2005 was longer, the positive rate of EEG evoked test in 1989 was higher, and the control rate of multiple drugs (three drugs) was higher in 1989. Conclusion the international anti-epileptic union diagnostic standard in 2005 can ensure the homogeneity of the patients and the seizure is easy to control. The second part of functional magnetic resonance study on blood oxygen-dependent epilepsy in children with aphasia Objective to investigate the metabolic changes of brain regions in children with aphasia. Methods EEG-fMRI was used to scan the BOLD signal during the seizure and interictal period, and the generalized linear model was used to detect the changes of activation and inhibition in the brain region. Results A total of 16 patients showed increased fMRI signal in thalamus, frontal cortex, primary visual area, auditory area, motor cortex and parietal lobe during electrical-clinical seizure 36 times and 3 Hz spike and slow wave discharges during EEG-fMRI scan. Cingulate gyrus and basal ganglia. Conclusion thalamus and frontal cortex are important structures involved in pathophysiological mechanism of aphasia.
【学位授予单位】：南京大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R742.1

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