本文選題：青少年肌陣攣癲癇 + 體感誘發(fā)電位�。� 參考：《實用醫(yī)學(xué)雜志》2017年05期

【摘要】：目的:通過探討青少年肌陣攣癲癇(JME)體感誘發(fā)電位(SEP)及事件相關(guān)電位P300的變化特點,分析其在癲癇患者中的臨床應(yīng)用價值,為JME的發(fā)病機制、診斷及監(jiān)測治療效果提供神經(jīng)電生理學(xué)依據(jù)。方法:選取28例JME(病例組)及30例年齡、性別、文化程度、身高相匹配的健康志愿者(對照組),分別于用藥前、藥物治療1年后進行SEP、P300檢測。結(jié)果:(1)與對照組比較,病例組SEP波幅均明顯升高(P=0.000),異常率75%(21/28),SEP潛伏期均無統(tǒng)計學(xué)差異(均P0.05);P300潛伏期明顯延長(P=0.000),其中2例P300分化差,9例潛伏期明顯延長,異常率39%(11/28),P300波幅差異無統(tǒng)計學(xué)意義(P=0.110)。(2)與治療前比較,治療后SEP波幅均明顯降低(均P0.05),P300潛伏期明顯縮短(P=0.001)。(3)病例組SEP波幅與P300潛伏期之間呈正相關(guān)關(guān)系(r=0.818,P=0.000)。結(jié)論:JME患者SEP皮層各波波幅明顯增高,常伴有巨大的SEP,因此SEP可以為JME的發(fā)病機制及診斷提供電生理學(xué)依據(jù),且對JME患者伴隨認(rèn)知發(fā)育異常及臨床下病變早發(fā)現(xiàn)、早干預(yù)。SEP與P300之間存在明顯的相關(guān)性,動態(tài)監(jiān)測SEP皮層波幅減低及P300潛伏期的縮短情況,可共同作為抗癲癇藥物療效的客觀評價指標(biāo)。
[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.
【作者單位】： 河北省兒童醫(yī)院神經(jīng)內(nèi)科;河北醫(yī)科大學(xué)第四醫(yī)院;
【基金】：2016年度河北省醫(yī)學(xué)科學(xué)研究重點課題計劃(編號:20160415)
【分類號】：R742.1

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