抽动障碍儿童的脑电图与临床研究

发布时间：2018-03-12 21:05

本文选题：抽动障碍　切入点：脑电图　出处：《重庆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:分析抽动障碍患儿的脑电图特点,探讨抽动障碍患儿脑电图异常及其特征,不同性别、年龄脑电图异常的差异性,并探讨抽动障碍患儿视频脑电图和普通脑电图异常的差异性。方法:分析我院2014年1月~2017年1月已行脑电图检查的抽动障碍患儿的一般资料包括性别、年龄(分为幼儿期、学龄前期、学龄期、青春期)及脑电图结果(分为正常、背景异常及痫性放电),并比较抽动障碍患儿不同年龄、性别的脑电图异常差异性,以及视频脑电图和普通脑电图在抽动患儿表现中的差异性。结果:(1)共6887例抽动障碍患儿纳入研究,平均年龄7.13±2.544岁,男女比例为3.97:1,脑电图总异常率7.56%,其中背景异常占2.18%,痫性放电占6.4%,二者均有占1.02%,提示抽动障碍患儿脑电图异常以痫性放电异常为主。(2)痫性放电中,颞区61%,顶区31.52%,中央区26.08%,枕区23.13%,额区20.43%,提示痫性放电部位主要在颞区;痫性放电中,双侧放电37.41%,单侧放电62.59%,提示主要为单侧放电。(3)女性患儿中,总异常率8.95%,其中2.89%有背景异常,7.14%有痫性放电,而男性患儿中,总异常率7.22%,其中2.0%为异常背景,6.22%为痫性放电,背景异常率、痫性放电率男女比较差异无统计学意义。(4)脑电图正常组平均年龄7.16±2.570岁,痫性放电组平均年龄6.86±2.23岁,背景异常组平均年龄6.79±2.56岁,痫性放电组年龄小于脑电图正常组,差异有统计学意义。幼儿组患儿背景异常3.85%,痫性放电4.54%,而学龄前期组患儿背景异常3.99%,痫性放电7.04%,学龄期背景异常0.86%,痫性放电6.29%,青春期背景异常0%,痫性放电4.69%。学龄前期背景异常高于其他组,差异有统计学意义;各组痫性放电率相比无显著差异。(5)常规脑电图检查中,总异常率为6.92%,背景异常占1.94%,痫性放电占6.04%,而视频脑电图检查中,异常率为9.74%,背景异常占2.99%,痫性放电占7.64%,视频脑电图检查异常率和痫性放电率均高于常规脑电图,有显著差异。结论:(1)抽动障碍患儿脑电图异常率高达7.56%,主要异常为痫性放电,占6.4%,主要位于颞区部位,痫性放电率与正常儿童无差别;(2)女性抽动障碍患儿与男性抽动障碍患儿比较,脑电图痫性放电率和背景异常率无明显差异;(3)与脑电图正常组比较,伴有痫性放电患儿年龄偏小,学龄前期抽动障碍患儿脑电图背景异常率最高;(4)和普通脑电图相比,视频脑电图的敏感性更高。
[Abstract]:Objective: to analyze the electroencephalogram (EEG) characteristics of children with tic disorder, and to explore the differences of EEG abnormality among different genders and ages. Methods: the general data of children with tic disorder from January 2014 to January 2017 were analyzed, including sex, age (divided into early childhood). Results of EEG (normal, abnormal background and epileptic discharge) and EEG in preschool, school-age and adolescence were compared. Results: a total of 6887 children with tic disorder were included in the study, with an average age of 7.13 卤2.544 years. The ratio of male to female was 3.97: 1. The total abnormal rate of EEG was 7.56. The background abnormality was 2.18, epileptic discharge was 6.4, both were 1.02. It was suggested that the abnormal EEG of children with tic disorder was mainly abnormal epileptic discharge. 61th of the temporal region, 31.52% of the parietal region, 26.08 of the central region, 23.13 of the occipital area, 20.43of the frontal area, suggesting that the epileptic discharge was mainly located in the temporal region, the bilateral discharge was 37.41 in the epileptic discharge, and the unilateral discharge was 62.59. The total abnormal rate was 8.95%, of which 2.89% had background abnormalities and 7.14% had epileptic discharges. In male children, the total abnormal rate was 7.22%, of which 2.0% were abnormal background discharges, 6.22% were epileptic discharges, and the background abnormality rate was 7.22%. The average age of normal EEG group was 7.16 卤2.570 years old, the average age of epileptic discharge group was 6.86 卤2.23 years old, the average age of background abnormal group was 6.79 卤2.56 years old, the average age of epileptic discharge group was less than that of normal EEG group. The difference was statistically significant: background abnormality 3.85, epileptic discharge 4.54, and preschool children 3.99, epileptic discharge 7.04, abnormal school-age 0.86, epileptic discharge 6.29, adolescent background abnormal 0, epileptic discharge 4.69. The background anomalies in Prophase were higher than those in other groups. There was no significant difference in the epileptic discharge rate among the three groups. The total abnormal rate was 6.92, the background abnormality was 1.94, and the epileptic discharge was 6.04, while in the video EEG examination, the total abnormal rate was 6.92, and the epileptic discharge was 6.04. The abnormal rate was 9.74%, background abnormality was 2.99%, epileptic discharge was 7.64%. The abnormal rate of video EEG and epileptic discharge were significantly higher than that of routine EEG. Conclusion the abnormal rate of EEG in children with twitching disorder is as high as 7.56 and the main abnormality is epileptic discharge. The rate of epileptic discharge was not different from that of normal children. There was no significant difference in epileptic discharge rate and background abnormality rate between female and male children with tic disorder. (3) there was no significant difference between epileptic discharge rate and background abnormality rate in normal EEG group, and there was no significant difference between epileptic discharge rate and background abnormal rate in EEG group. The sensitivity of video EEG was higher in children with epileptic discharges than general EEG.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749.94

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