立体定向和功能性神经外科杂志 ›› 2024, Vol. 37 ›› Issue (5): 267-273.DOI: 10.19854/j.cnki.1008-2425.2024.05.0003

• 论著 • 上一篇    下一篇

局灶性癫痫发作的脑电时空特征及其与患者耐药的相关性分析

蒋丹, 杨小芳, 康瑜   

  1. 629000 遂宁市 四川省遂宁市中心医院神经电生理室
  • 收稿日期:2023-11-20 出版日期:2024-10-25 发布日期:2024-12-17
  • 通讯作者: 康瑜 85298141@qq.com

Temporal and spatial characteristics of EEG in focal epileptic seizures and their correlation with drug resistance

Jiang Dan, Yang Xiaofang, Kang Yu   

  1. Department of Neuroelectrophysiology,Suining Central Hospital,Suining,629000,China
  • Received:2023-11-20 Online:2024-10-25 Published:2024-12-17
  • Contact: Kang Yu 85298141@qq.com

摘要: 目的 探究局灶性癫痫发作的脑电时空特征及其与患者耐药的相关性。方法 选取2020年1月~2022年7月于我院就诊的123例完善脑电图(EEG)检查的局灶性癫痫发作患者进行研究,按照是否耐药分为耐药组(45例)和敏感组(78例);比较耐药组和敏感组患者临床资料及脑电时空特征;多因素logistic回归分析局灶性癫痫发作患者发生耐药性的影响因素;建立结构方程预测模型并进行验证。结果 敏感组的脑电总能量及脑电发作水平明显高于耐药组(P<0.001);敏感组的α能量占比明显低于耐药组( P=0.015),γ能量占比明显高于耐药组(P<0.001);病程≥10年、发作频率≥4次/月、初次用药疗效差、颞叶起源、脑卒中史、神经生理发作异常、治疗后EEG痫样放电是局灶性癫痫发作患者发生耐药性的独立危险因素(P<0.05);结构方程模型整体适配情况较优,能很好地反映各影响因素与局灶性癫痫发作患者耐药性发生的关系;模型的收敛效度和组合信度良好。结论 病程≥10年、发作频率≥4次/月、初次用药疗效差、颞叶起源、脑卒中史、神经生理发作异常、治疗后EEG痫样放电是局灶性癫痫发作患者发生耐药性的独立危险因素。耐药性局灶性癫痫患者与敏感组患者的脑电频谱能量存在特征差异。

关键词: 局灶性癫痫, 脑电时空特征, 耐药

Abstract: Objective To explore the spatio-temporal characteristics of electroencephalogram (EEG) in patients with focal epilepsy and its correlation with drug resistance. Methods A total of 123 patients with focal epileptic seizures who underwent electroencephalogram (EEG) examination in our hospital from January 2020 to July 2022 were selected for this study.According to whether they were resistant to drug,they were divided into a drug-resistant group (45 cases) and a sensitive group (78 cases).The clinical data and electroencephalogram (EEG) spatio-temporal characteristics were compared between the drug resistance group and the sensitive group.Multivariate logistic regression was used to analyze the influencing factors of drug resistance in patients with focal seizures.The structural equation prediction model was established and verified. Results The total EEG energy and the level of EEG seizures in the sensitive group were significantly higher than those in the resistant group (P<0.001).The proportion of α energy in the sensitive group was significantly lower than that in the drug-resistant group (P=0.015),and the proportion of γ energy was significantly higher than that in the drug-resistant group (P<0.001).The course of disease ≥10 years,seizure frequency≥4 times/month,poor initial treatment effect,temporal lobe origin,stroke history,abnormal neurophysiological seizure,and epileptic discharge after treatment were independent risk factors for drug resistance in patients with focal epilepsy (P<0.05).The overall fitness of the structural equation model was better,which could well reflect the relationship between various influencing factors and the occurrence of drug resistance in patients with focal epilepsy.The convergent validity and combined reliability of the model were good.The course of disease≥10 years,seizure frequency≥4 times/month,poor initial treatment effect,temporal lobe origin,stroke history,abnormal neurophysiological seizure,and epileptic discharges after treatment are independent risk factors for drug resistance in patients with focal epilepsy.There are characteristic differences in the power spectrum of EEG between drug-resistant focal epilepsy patients and sensitive focal epilepsy patients. Conclusion The course of disease≥10 years,seizure frequency≥4 times/month,poor initial treatment effect,temporal lobe origin,stroke history,abnormal neurophysiological seizure,and epileptic discharges after treatment are independent risk factors for drug resistance in patients with focal epilepsy.There are characteristic differences in the power spectrum of EEG between drug-resistant focal epilepsy patients and sensitive focal epilepsy patients.

Key words: Focal epilepsies, Temporal and spatial characteristics of EEG, Drug resistant

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