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Epilepsy Patients with Perinatal and Neonatal Abnormalities: Linical Features, Interictal SPECT, Video-EEG and Image

Author: LiuYaQing
Tutor: WangWeiMin
School: Lanzhou University
Course: Neurology
Keywords: Epilepsy Perinatal Neonatal period Interictal SPECT Video EEG Imaging Epileptogenic focus SPECT V-EEG Consistency
CLC: R742.1
Type: Master's thesis
Year: 2011
Downloads: 12
Quote: 0
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Abstract


Clinical, SPECT, V-EEG and imaging characteristics of the first part of perinatal or neonatal period abnormal in patients with epilepsy Objective: To understand the relationship between epilepsy and perinatal and neonatal period abnormal factors, explore with perinatal or neonatal period abnormal history clinical characteristics of patients with epilepsy, interictal SPECT, video EEG and imaging (CT / MRI) features; explore interictal SPECT, V-EEG and CT / MRI in the diagnosis and treatment of epilepsy value. Method to: collect 2008.02-20010.02 cases diagnosed epilepsy Lanzhou University Hospital Epilepsy Center, after detailed history, according to the inclusion and exclusion criteria, elected to the 150 cases of clear perinatal or neonatal period abnormal in patients with epilepsy. Detailed record of the patient's general condition, determine the type of seizure, interictal SPECT, V-EEG and imaging studies. Application SPSS17.0 statistical software for statistical analysis interictal SPECT V-EEG and CT / MRI examination results. Results: The patients there are 20 kinds of perinatal risk factors for preterm birth, neonatal asphyxia, neonatal hypoxic-ischemic encephalopathy and neonatal intracranial hemorrhage more common. Age of onset in less than 14 years old accounted for 88%; seizure type is generalized and partial, half and half, followed by a generalized tonic-clonic seizures, complex partial seizures, simple partial seizures, secondary generalized tonic-clonic episodes more common; including 11 patients with mental retardation. Interictal SPECT abnormalities in 128 cases (85.3%); hypoperfusion in 63 cases (49.2%), and high perfusion in 55 patients (43%) - hypoperfusion 10 cases (7.8%), abnormal perfusion stove 224, high temporal lobe accounting for 41.1%. V-EEG anomaly of 132 cases (88%) of the 117 cases, was epileptic discharge, focal abnormalities in 49 cases (37.1%). Radiographic abnormalities in 69 patients (50%) lesions to brain atrophy and brain development abnormality is more common. Between attacks of SPECT and V-EEG positive rate difference was not statistically significant (x2 = 0.462, P = 0.497 gt; 0.05), the interictal period SPECT and CT / MRI positive rate difference was statistically significant (x2 = 41.517, P lt; 0.01). Conclusion: The perinatal and neonatal abnormalities in patients with epilepsy and more in childhood-onset seizure types in both generalized and partial; the interictal SPECT V-EEG positive rate is high, both fairly; V-EEG manifestations epilepsy discharges to the extensive common. Imaging of temporal lobe atrophy and brain developmental disorders more common. The interictal SPECT V-EEG and CT / MRI positioning are more common in the temporal lobe. Standardized history, combined with clinical onset form of the interictal SPECT V-EEG and CT / MRI examination methods, epilepsy diagnosis, classification, treatment and prognostic evaluation of great significance. The second part of interictal SPECT, V-EEG and GT / MRI diagnosis of epileptic foci consistency Objective: To study the interictal phase SPECT, V-EEG and imaging studies of the consistency of the epileptic focus localization diagnosis. Methods: 2008.02 to 20010.02 in 138 patients Lanzhou University Hospital Epilepsy Center diagnosed epilepsy, and interictal SPECT V-EEG and imaging studies (MRI / CT) three check. Compare interictal SPECT, V-EEG and CT / MRI positioning rate, and the positioning of the epileptic focus, the consistency of pairwise comparisons. Results: 138 patients, interictal SPECT abnormalities was 86.2% (119/138), of which 57 cases showed focal abnormal single leaf. V-EEG abnormality rate was 90% (124/138), the focal abnormal discharge in 43 cases (34.7%). Imaging (CT / MRI) the abnormal 69 cases (50%), localized disease, 48 cases (69.6%). Consistency compare the results of the three kinds of epileptic foci check twenty-two joint positioning: positioning consistency SPECT V-EEG and SPECT and CT / MRI positioning consistency compared the difference was statistically significant (x2 = 7.571, P = 0.006 lt; 0.01); the SPEC and CT / MRI positioning consistency V-EE and CT / MRI positioning consistency compared the difference was statistically significant (x2 = 7.052, P = 0.008 lt; 0.01). Interictal SPECT and CT / MRI combination is consistent with the 40.6% of patient positioning. Conclusion: SPECT V-EEG epilepsy patients positive rate was significantly higher than the imaging studies, SPECT and CT / MRI positioning better consistency, a clear cause patients is a practical and joint inspection of the economy mode.

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CLC: > Medicine, health > Neurology and psychiatry > Neurology > Brain diseases > Epilepsy
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