癫痫病EEG演讲.pptVIP

Ohtahara综合征也称大田原综合征 大田原综合征的起病年龄在3个月之内，多数早至1个月之内。主要发作类型为痉挛性发作，可以为成串发作，类似婴儿痉挛发作，也可仅为单次痉挛。清醒和睡眠期均可有发作。其他发作形式如部分运动性发作、半侧惊厥发作也可出现，但很少有肌阵挛发作。 患儿有严重的精神运动发育落后或停滞。 神经影像学常有明显的异常发现。 暴发——抑制是大田原综合征的特征性表现，也是本症重要的诊断依据。睡眠及清醒时持续存在。也可为不对称或不同步的爆发一抑制。 本症与婴儿痉挛症的主要鉴别点为后者起病年龄稍晚（高峰为4-6个月），EEG主要表现为高峰节律紊乱。 PLS’09 Beijing, China, September 7, 2009 Ohtahara syndrome FIG. 1. Interictal EEG of a 2-month-old boy with Ohtahara syndrome shows bilaterally synchronous suppression-burst pattern both during (above) wakefulness and (below) sleep. Calibrations are 1 second and 50 microvolts. From: ? Ohtahara: J Clin Neurophysiol, Volume 20(6).November/December 2003.398-407 PLS’09 Beijing, China, September 7, 2009 West综合征 3-7个月婴儿多见 发育迟缓 屈颈、弯腰样发作 EEG上呈高峰失律 PLS’09 Beijing, China, September 7, 2009 Hypsarrhythmia PLS’09 Beijing, China, September 7, 2009 Hypsarrhythmia FIG. 2. Digital recording of a hypsarrhythmic pattern in a 23-month-old infant.  PLS’09 Beijing, China, September 7, 2009 Hypsarrhythmia with Increased Interhemispheric Synchronization FIG. 3. Digital recording of hypsarrhythmia with increased interhemispheric synchronization in a 22-month-old infant. Note increased synchronization of frontal slow and sharp and slow wave activity. Sample shown at reduced sensitivity. PLS’09 Beijing, China, September 7, 2009 Asymmetric Hypsarrhythmia FIG. 4. Digital recording of asymmetric hypsarrhythmia in a 13-month-old infant. Sample shown at reduced sensitivity.  PLS’09 Beijing, China, September 7, 2009 Hypsarrhythmia with Episodes of Voltage Attenuation FIG. 6. Digital recording of suppression-burst variant of hypsarrhythmia in a 3-month-old infant. Sample shown at reduced sensitivity PLS’09 Beijing, China, September 7, 2009 Lennox-Gastaut综合征 学龄前期发病 多伴智能发育障碍 多种发作形式 EEG上慢棘-慢波 治疗困难，予后差 PLS’09 Beijing, China, September 7, 2009 Symptomatic Generalized Epilepsy Lennox-Gastaut Syndrome PLS’09 Beijing, China, September 7, 2009 部分性发作 又称限局性或局灶性发作 异常发电起源于脑的某一部位，故临床发作和脑电图异常均有局灶性起源 发作时意识存在 简单部分性发作(simpl