儿童全面性强直阵挛发作及癫痫性痉挛发作近日生物节律特征的初步研究
发布时间：2018-08-23 10:51
【摘要】：目的:探索儿童全面性强直阵挛发作及癫痫性痉挛发作的近日生物节律特征,以了解两种类型癫痫发作各自的近日分布特点,为癫痫的治疗提供新的思路。方法:选择南方医科大学珠江医院儿科中心脑电图室自2015年9月到2017年02月期间所进行的长程视频脑电图监测的患儿(年龄0岁-14岁)共43例,我们共发现脑电图确认的临床发作事件182次。其中,全面强直阵挛发作患儿共20例(共51次全面性强直阵挛发作事件);癫痫性痉挛发作患儿23例(共131次癫痫性痉挛发作事件)。我们把51次全面性强直阵挛发作事件及131次癫痫性痉挛发作事件作为本次研究的对象。癫痫发作类型定义根据2010年ILAE术语。我们通过分别观察儿童全面性强直阵挛发作及癫痫性痉挛发作昼夜(6:00am-6:00pm为白天)分布规律、睡眠/觉醒分布规律及时间段(连续3个小时为一个时间单位将24小时分为8个时间段)分布规律,对其各自发作的近日生物节律特征进行初步研究。同时,我们还通过观察发作昼夜分布规律、睡眠/觉醒分布规律及时间段分布规律,初步研究头颅磁共振异常与头颅磁共振正常的癫痫患儿全面性强直阵挛发作及癫痫性痉挛发作近日生物节律特征和癫痫综合征与非癫痫综合征患儿癫痫性痉挛发作的近日生物节律特征。我们应用秩转换的非参数检验方法进行统计分析。p0.05、0.01、0.001则认为有统计学意义。结果:本研究共分析了 20例全面性强直阵挛发作的癫痫患儿(男17人、女3人;平均年龄4.12(0.33-13.75岁))的51次全面性强直阵挛发作事件。全面性强直阵挛发作多发于睡眠状态(p0.05);昼夜发作分布无统计学意义(p0.05);全天发作高峰集中于12:00-15:00和0:00-03:00(p0.05);睡眠期发作高峰时段为12:00-15:00和0:00-03:00(p0.05),觉醒期无明显发作高峰时间段(p0.05)。头颅磁共振异常的患儿全面性强直阵挛发作多于睡眠状态发生(p0.05);头颅磁共振检查正常的患儿睡眠与觉醒状态下发作频率无明显差异(p0.05)。本研究还分析了 23名癫痫性痉挛患儿(其中男14人、女9人;平均年龄1.53岁(0.25-6.17岁)),的131次癫痫性痉挛发作事件。癫痫性痉挛发作多集中于白天(p0.001)和觉醒状态(p0.01),多集中于 09:00-12:00、06:00-09:00 及15:00-18:00三个时段(p0.001)。头颅磁共振异常的癫痫性痉挛患儿发作多集中白天(p0.001)和觉醒(p0.001),高峰时段集中于白天06:00-09:00及09:00-12:00两个时段(p0.001)。癫痫综合征患儿及非癫痫综合征患儿癫痫性痉挛发作都集中于白天(p0.05)和觉醒状态(p0.05)。但是,癫痫综合征患儿发作高峰时段在白天09:00-12:00及15:00-18:00两个时段(p0.05)。非癫痫综合征患儿多发于白天06:00-09:00及09:00-12:00两个时段(p0.01)。结论:儿童全面性强直阵挛发作及癫痫性痉挛发作都存在各自独特的近日生物节律特征。掌握全面性强直阵挛发作及癫痫性痉挛发作的近日生物节律可为癫痫研究提供一个全新的思路,其机制有待进一步研究。
[Abstract]:Objective: to explore the circadian rhythm characteristics of generalized tonic-clonic seizure and epileptic spasm in children in order to understand the perihelion distribution of the two types of seizures and to provide a new idea for the treatment of epilepsy. Methods: a total of 43 children (aged 0-14 years) who were monitored by electroencephalogram (EEG) from September 2015 to February 2017 in the Electroencephalogram Room of Zhujiang Hospital, Southern Medical University, were selected. We found 182 clinical seizures confirmed by EEG. There were 20 children with generalized tonic-clonic seizure (51 generalized tonic-clonic seizures) and 23 children with epileptic spasm (131 seizures). We studied 51 generalized tonic-clonic seizures and 131 epileptic spasms. Epileptic seizure type is defined according to 2010 ILAE terminology. We observed the diurnal distribution of generalized tonic-clonic seizure (6:00am-6:00pm) and epileptic spasm (6:00am-6:00pm) in children. The distribution of sleep / arousal and the distribution of different periods (24 hours were divided into 8 periods in a time unit of 3 hours in a row) were studied, and their circadian rhythms were studied. At the same time, we also observed the circadian distribution, the sleep / awakening distribution and the temporal distribution of the attack. Preliminary study on the characteristics of circadian rhythm of generalized tonic-clonic seizure and epileptic spasm in epileptic children with abnormal cranial magnetic resonance and normal cranial magnetic resonance and epileptic spasm in children with epilepsy syndrome and non-epileptic syndrome The circadian rhythms of the work. We use the nonparametric test method of rank conversion to carry on the statistical analysis. P 0.05 0. 01 0. 001 is considered to have statistical significance. Results: a total of 51 generalized tonic-clonic seizures (17 males, 3 females; mean age 4.12 (0.33-13.75 years) in 20 children with generalized tonic-clonic seizures were analyzed. The incidence of generalized tonic-clonic seizures was mostly in sleep (p0.05), the distribution of diurnal seizures was not statistically significant (p0.05), the peak of full-day seizures was 12: 00-15: 00 and 0: 00-03: 00 (p0.05), the peak periods of sleep seizures were 12: 00-15: 00 and 000-03: 00 (p0.05), and there was no obvious peak period in arousal (p0.05). The incidence of generalized tonic-clonic seizure in children with abnormal cranial magnetic resonance was more than that in sleep (p0.05), but there was no significant difference in frequency between sleep and arousal in children with normal cranial magnetic resonance examination (p0.05). This study also analysed 23 children with epileptic spasm (14 males and 9 females) with an average age of 1. 53 years (0. 25-6. 17 years old). Epileptic seizures were mainly concentrated in the daytime (p0.001) and arousal state (p0.01), and were mainly concentrated in three periods: 09: 00-12: 00 06: 00-09: 00 and 15: 00-18: 00 (p0.001). The seizures of epileptic spasm with abnormal cranial magnetic resonance were mainly concentrated in daytime (p0.001) and arousal (p0.001), and the peak periods were 0600-09: 00 and 0900-12: 00 (p0.001). Epileptic spasmodic seizures in children with epilepsy syndrome and non-epileptic syndrome were concentrated in daytime (p0.05) and arousal state (p0.05). However, the peak period of seizures in children with epilepsy syndrome was at 9: 00-12: 00 and 15: 00-18: 00 during the day (p0.05). Children with non-epileptic syndrome were found to be in two periods (p 0.01): 06: 00-09: 00 and 09: 00-12: 00 during the day. Conclusion: children with generalized tonic-clonic seizure and epileptic spasm have their own unique circadian rhythms. Mastering the circadian rhythm of generalized tonic-clonic seizure and epileptic spasm can provide a new idea for the study of epilepsy and its mechanism needs further study.
【学位授予单位】：南方医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R742.1
本文编号：2198857
[Abstract]:Objective: to explore the circadian rhythm characteristics of generalized tonic-clonic seizure and epileptic spasm in children in order to understand the perihelion distribution of the two types of seizures and to provide a new idea for the treatment of epilepsy. Methods: a total of 43 children (aged 0-14 years) who were monitored by electroencephalogram (EEG) from September 2015 to February 2017 in the Electroencephalogram Room of Zhujiang Hospital, Southern Medical University, were selected. We found 182 clinical seizures confirmed by EEG. There were 20 children with generalized tonic-clonic seizure (51 generalized tonic-clonic seizures) and 23 children with epileptic spasm (131 seizures). We studied 51 generalized tonic-clonic seizures and 131 epileptic spasms. Epileptic seizure type is defined according to 2010 ILAE terminology. We observed the diurnal distribution of generalized tonic-clonic seizure (6:00am-6:00pm) and epileptic spasm (6:00am-6:00pm) in children. The distribution of sleep / arousal and the distribution of different periods (24 hours were divided into 8 periods in a time unit of 3 hours in a row) were studied, and their circadian rhythms were studied. At the same time, we also observed the circadian distribution, the sleep / awakening distribution and the temporal distribution of the attack. Preliminary study on the characteristics of circadian rhythm of generalized tonic-clonic seizure and epileptic spasm in epileptic children with abnormal cranial magnetic resonance and normal cranial magnetic resonance and epileptic spasm in children with epilepsy syndrome and non-epileptic syndrome The circadian rhythms of the work. We use the nonparametric test method of rank conversion to carry on the statistical analysis. P 0.05 0. 01 0. 001 is considered to have statistical significance. Results: a total of 51 generalized tonic-clonic seizures (17 males, 3 females; mean age 4.12 (0.33-13.75 years) in 20 children with generalized tonic-clonic seizures were analyzed. The incidence of generalized tonic-clonic seizures was mostly in sleep (p0.05), the distribution of diurnal seizures was not statistically significant (p0.05), the peak of full-day seizures was 12: 00-15: 00 and 0: 00-03: 00 (p0.05), the peak periods of sleep seizures were 12: 00-15: 00 and 000-03: 00 (p0.05), and there was no obvious peak period in arousal (p0.05). The incidence of generalized tonic-clonic seizure in children with abnormal cranial magnetic resonance was more than that in sleep (p0.05), but there was no significant difference in frequency between sleep and arousal in children with normal cranial magnetic resonance examination (p0.05). This study also analysed 23 children with epileptic spasm (14 males and 9 females) with an average age of 1. 53 years (0. 25-6. 17 years old). Epileptic seizures were mainly concentrated in the daytime (p0.001) and arousal state (p0.01), and were mainly concentrated in three periods: 09: 00-12: 00 06: 00-09: 00 and 15: 00-18: 00 (p0.001). The seizures of epileptic spasm with abnormal cranial magnetic resonance were mainly concentrated in daytime (p0.001) and arousal (p0.001), and the peak periods were 0600-09: 00 and 0900-12: 00 (p0.001). Epileptic spasmodic seizures in children with epilepsy syndrome and non-epileptic syndrome were concentrated in daytime (p0.05) and arousal state (p0.05). However, the peak period of seizures in children with epilepsy syndrome was at 9: 00-12: 00 and 15: 00-18: 00 during the day (p0.05). Children with non-epileptic syndrome were found to be in two periods (p 0.01): 06: 00-09: 00 and 09: 00-12: 00 during the day. Conclusion: children with generalized tonic-clonic seizure and epileptic spasm have their own unique circadian rhythms. Mastering the circadian rhythm of generalized tonic-clonic seizure and epileptic spasm can provide a new idea for the study of epilepsy and its mechanism needs further study.
【学位授予单位】：南方医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R742.1
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