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目的:了解癫痫放电在自然睡眠各期及觉醒状态下分布情况,为癫痫的诊断与优化治疗提供客观参考依据。方法:筛选40例全身性强直—阵挛发作尚未用AEDs治疗的癫痫患者,用英国OXFORD Medilog 9200型动态脑电监测仪同时进行多导睡眠记录和动态脑电图记录。结果:40例中有33人记录到典型癫痫波(82.5%),30人记录到慢波阵发(75%),11人记录到α高尖阵发(27.5%)。结论:本研究提示典型癫痫放电和慢波发放主要在W和S_(1,2)较多,其次是在REM,在S_(3,4)相对较少,α高尖阵发主要是在W和S_(1,2),这说明痫样放电在觉醒和睡眠时均有相当的放电时间和次数。本研究还提示通过动态脑电图检测或结合多导睡眠图可详细准确了解痫样放电的24小时分布状况,对指导调整AEDs的用量和服用时间,实现癫痫优化治疗有重要意义。
OBJECTIVE: To understand the distribution of epileptic discharge in various stages of natural sleep and wakefulness, and provide an objective reference for the diagnosis and optimal treatment of epilepsy. METHODS: Forty patients with tonic-clonic seizures who had not yet been treated with AEDs were enrolled in this study. Polymorphic sleep recording and dynamic EEG recording were performed simultaneously with OXFORD Medilog 9200 dynamic EEG monitor. RESULTS: Thirty-three of the 40 patients recorded typical epileptic waves (82.5%), 30 recorded slow-wave burst (75%), and 11 recorded α-sharp burst (27.5%). Conclusion: This study suggests that typical epileptic discharges and slow waves mainly occur in W and S_ (1, 2), followed by REM, and relatively few in S_ (3,4) And S_ (1,2), indicating that epileptiform discharges have a considerable discharge time and frequency during awakening and sleep. The study also suggests that dynamic electroencephalogram detection or combined with polysomnography can be a detailed and accurate understanding of 24-hour distribution of epileptic discharge, the guidance and adjustment of the amount of AEDs and taking time, to achieve optimal treatment of epilepsy is of great significance.