青少年肌阵挛癫痫体感诱发电位、事件相关电位P300的特点分析与临床应用

发布时间：2018-05-06 00:21

本文选题：青少年肌阵挛癫痫 + 体感诱发电位　；参考：《实用医学杂志》2017年05期

【摘要】：目的:通过探讨青少年肌阵挛癫痫(JME)体感诱发电位(SEP)及事件相关电位P300的变化特点,分析其在癫痫患者中的临床应用价值,为JME的发病机制、诊断及监测治疗效果提供神经电生理学依据。方法:选取28例JME(病例组)及30例年龄、性别、文化程度、身高相匹配的健康志愿者(对照组),分别于用药前、药物治疗1年后进行SEP、P300检测。结果:(1)与对照组比较,病例组SEP波幅均明显升高(P=0.000),异常率75%(21/28),SEP潜伏期均无统计学差异(均P0.05);P300潜伏期明显延长(P=0.000),其中2例P300分化差,9例潜伏期明显延长,异常率39%(11/28),P300波幅差异无统计学意义(P=0.110)。(2)与治疗前比较,治疗后SEP波幅均明显降低(均P0.05),P300潜伏期明显缩短(P=0.001)。(3)病例组SEP波幅与P300潜伏期之间呈正相关关系(r=0.818,P=0.000)。结论:JME患者SEP皮层各波波幅明显增高,常伴有巨大的SEP,因此SEP可以为JME的发病机制及诊断提供电生理学依据,且对JME患者伴随认知发育异常及临床下病变早发现、早干预。SEP与P300之间存在明显的相关性,动态监测SEP皮层波幅减低及P300潜伏期的缩短情况,可共同作为抗癫痫药物疗效的客观评价指标。
[Abstract]:Objective: to investigate the changes of somatosensory evoked potential (SEP) and event-related potential (P300) in juvenile myoclonic epilepsy (JME), and to analyze its clinical application value in epileptic patients, which is the pathogenesis of JME. Diagnosis and monitoring of therapeutic effects provide basis for neuroelectrophysiology. Methods: a total of 28 JME-matched healthy volunteers (control group) and 30 healthy volunteers (age, sex, education level, height matched) were tested for SEPP300 before and one year after drug treatment. Results compared with the control group, the amplitudes of SEP in the case group were significantly higher than those in the control group. There was no significant difference in the latency of SEP between the patients and the control group. There was no significant difference in the latency of SEP between the two cases (all P0.05% P300 and P300 0.000), and two cases with poor differentiation of P300 and 9 cases with prolonged latency. There was no significant difference in the amplitudes of P300 (11 / 28) and before treatment (P < 0. 05). The amplitude of SEP was significantly decreased after treatment (P 0. 05). The latency of P300 was significantly shortened (P 0. 05). There was a positive correlation between the amplitude of SEP and the latency of P300 (r 0. 818 ~ 0. 000). Conclusion the amplitudes of SEP cortical waves are significantly increased in patients with SEP, and often accompanied by large SEPs. Therefore, SEP can provide electrophysiological evidence for the pathogenesis and diagnosis of JME, and early detection of cognitive dysplasia and clinical lesions in JME patients. There was a significant correlation between early intervention. SEP and P300. Dynamic monitoring of the decrease of cortical amplitude of SEP and the shortening of P300 latency could be used as an objective evaluation index for the efficacy of antiepileptic drugs.
【作者单位】：河北省儿童医院神经内科;河北医科大学第四医院;
【基金】：2016年度河北省医学科学研究重点课题计划(编号:20160415)
【分类号】：R742.1

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