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1 病例报告患者女,24岁.1992年3月20日入院,患者于半年前无任何诱因工作中突然不省人事摔倒在地,当时呼唤无反应,无肢体抽搐及尿便失禁,1分钟后自行缓解,醒后自觉乏力,对发作无记忆.半月后上述症状再次发作,自此发作渐频繁,由每1～2天发作1次发展到1天发作数次,入院前则为1～2小时即发作1次,持续时间也渐延长至3～4分钟.发作无昼夜之分,也无论有无他人在场,骑自行车时也有发作,因此头部摔伤2次.入院查体无神经系统阳性体征.性格开朗,精神心理学方面测试正常.住院期间对其发作过程作了详细观察,发现除发作时意识不清、呼吸停止、肌张力低下外余者如瞳孔,心率、心电图、血氧饱和度、体温、血压均正常,无病理征,无尿失禁.酷似睡眠状态,但唤不醒.入院后辅助检查:头颅CT平扫,增强及MRI均示右侧脑室略扩大.心功能检查正常,BAEP、VEP均无异常.多次小睡潜伏试验:不符合发作性睡病.多导仪夜间监测:不符合睡眠呼吸暂停综合病征.脑血管造影无异常.睡眠脑电监测:在7小时睡眠中于3～4小时Ⅰ、Ⅱ期睡眠中可见爆发性单个150μV尖波(10cps),随继可见爆发性尖波及3～4cps之棘慢波综合连续出现,以高尖波为主的尖波群达20秒,符合EP、脑电图(用药前)有爆发性阵
1 case report The patient was female, aged 24. On March 20, 1992, she was hospitalized and the patient suddenly fell unconscious during work six months ago, calling for no reaction, no convulsions and urinary incontinence for 1 minute After self-consciously awake, wake up consciously fatigue, no memory of seizures. Half a month after the onset of the recurrence of the symptoms, since the onset of the more frequent attacks from 1 to 2 days 1 to 1 day to attack several times, before admission is 1 ~ 2 hours that attack 1 times, the duration also gradually extended to 3 to 4 minutes. No episodes of day and night episodes, no matter whether there is any presence, there are seizures while riding a bike, so the head falls 2. Admission examination without nerve Positive signs of the system. Cheerful, psychologically normal test. During the hospital for its seizures made a detailed observation found that in addition to episodes of confusion, respiratory arrest, low muscle tension such as pupil, heart rate, ECG, blood Oxygen saturation, body temperature, blood pressure were normal, no pathological signs, no urinary incontinence .Such as sleep, but wake up .Accessive examination: head CT scan, enhancement and MRI showed a slight enlargement of the right ventricle. Check the normal, BAEP, VEP no abnormalities Latent test: does not meet the narcolepsy. Multi-channel instrument night monitoring: does not meet the comprehensive syndrome of sleep apnea. Cerebral angiography without abnormalities. Sleep EEG monitoring: in 7 hours of sleep in 3 to 4 hours Ⅰ, Ⅱ sleep (10cps), followed by explosive spikes and 3 ~ 4cps Spikes and Slow Waves. The sharp wave group with high spike wave is 20 seconds, which is in accordance with EP, EEG (Before treatment) have explosive array