热性惊厥儿童脑电图特点及异常 部位对后期癫痫发生的影响

The Influence of Electroencephalogram Characteristics and Abnormal Sites on the Occurrence of Late Epilepsy in Children with Febrile Convulsion

摘要:

〔摘 要〕 目的：研究热性惊厥儿童脑电图特点及异常部位对后期癫痫发生的影响。 方法：选取河南大学淮河医院 2018 年 1 月至 2022 年 6 月收治的 116 例热性惊厥儿童作为研究对象。脑电图检查正常儿童 76 例（脑电图正常组）， 脑电图异常儿童 40 例（脑电图异常组）。比较脑电图正常及异常儿童临床病理因素，分析不同部位脑电图异常儿童 的癫痫发生率。 结果：两组热性惊厥儿童脑电图表现在性别、年龄、热性惊厥家族史、惊厥类型上比较，差异无统计 学意义（P ＞ 0.05）；两组热性惊厥儿童在热性惊厥持续时间、热性惊厥再发次数、初次发作年龄、热性惊厥表现上 比较，差异具有统计学意义（P ＜ 0.05），脑电图异常组热性惊厥儿童热性惊厥持续时间、热性惊厥再发次数及全身 抽搐比例显著高于脑电图正常组儿童，差异具有统计学意义（P ＜ 0.05），初次发作年龄显著低于脑电图正常组儿童， 差异具有统计学意义（P ＜ 0.05）。40 例脑电图异常热性惊厥儿童中弥漫性异常 23 例（57.5 %）、额颞叶区异常 8 例 （20.0 %）及顶枕叶区异常 9 例（22.5 %），弥漫性异常显著高于额颞叶区及顶枕叶区，差异具有统计学意义（P ＜ 0.05）。 本组 116 例热性惊厥儿童中癫痫患儿 14 例（12.1 %），均发生在脑电图异常组儿童，脑电图额颞叶区异常儿童癫痫 发生率显著高于弥漫性异常及顶枕叶区异常儿童，差异具有统计学意义（P ＜ 0.05）。 结论：热性惊厥儿童脑电图异 常与热性惊厥持续时间、热性惊厥再发次数、初次发作年龄、热性惊厥表现有关，脑电图额颞叶区异常儿童癫痫发生 率显著升高，临床上对脑电图额颞叶区异常儿童应密切监测以改善其预后。

Abstract:

〔Abstract〕 Objective To study the effect of Electroencephalogram (EEG) characteristics and abnormal sites on the occurrence of late epilepsy in children with febrile convulsion. Methods A total of 116 children with febrile convulsion admitted to Huaihe Hospital of Henan University from January 2018 to June 2022 were selected as subjects. There were 76 cases of normal children (normal EEG group) and 40 cases of abnormal children (abnormal EEG group). The clinicopathologic factors of children with normal and abnormal EEG were compared to analyze the incidence of epilepsy in children with abnormal EEG in different parts. Results There was no significant difference between the two groups in gender, age, family history of febrile convulsion and type of convulsion (P > 0.05). There were statistically significant differences between the two groups in the duration of febrile convulsion, the number of recurrent febrile convulsion, the age of the first attack and the manifestations of febrile convulsion (P < 0.05). The duration of febrile convulsion, the number of recurrent febrile convulsion and the proportion of general convulsion in children with febrile convulsion in the abnormal EEG group were significantly higher than those in the normal EEG group. The differences were statistically significant (P < 0.05), and the age of first onset was significantly lower than that of the normal EEG group (P < 0.05). Among the 40 children with abnormal EEG heat convulsion, there were 23 cases (57.5 %) of diffuse abnormalities, 8 cases (20.0 %) of frontotemporal lobe abnormalities and 9 cases (22.5 %) of parieto-occipital lobe abnormalities. The diffuse abnormalities were significantly higher than those in frontotemporal lobe and parieto-occipital lobe regions, the differences were statistically significant (P < 0.05). Among the 116 children with febrile convulsion, 14 cases (12.1 %) had epilepsy, all of which occurred in the EEG abnormal group. The incidence of epilepsy in children with EEG abnormal frontotemporal region was significantly higher than that in children with diffuse and parieto-occipital region, with statistical significance (P < 0.05). Conclusion The abnormal EEG in children with febrile convulsion is related to the duration of febrile convulsion, the frequency of recurrent febrile convulsion, the age of the first attack, and the manifestations of febrile convulsion. The incidence of epilepsy in children with abnormal EEG frontotemporal lobe region is significantly increased, and the children with abnormal EEG frontotemporal lobe region should be closely monitored clinically to improve their prognosis.