| Backgroud and purposeVideo-EEG (VEEG) monitoring is a form of EEG monitoring, which uses digital camera devices to monitor patients and can simultaneously monitor the clinical manifestations and EEG activity in long time, can help to identify the artifact of EEG, and can also select multiple induced experiment as needed, which greatly improved the detection rate of abnormal EEG activity, and is an important clinical test methods. This purpose is to further explore the diagnosis and differential diagnosis of video-EEG (VEEG) in epilepsy, non-epileptic seizure and other diseases, and psychological conditions of patients were assessed and analyzed for clinical practice.MethodsThe cases derived from the patients who did video-EEG (VEEG) inspection in VEEG Room from October 2009 to October 2010 in the First Affiliated Hospital of Zhengzhou University, total 250 cases. The males accounts for 143 cases (57.2%), females accounts for 107 cases (42.8%). Age from 16 months to 72 years old, the mean age is 22.4 years old. Among them, the age≤14 is 93 cases(37.2%), the age of 15～29 is 104 cases(41.6%), the age of 30～44 is 24 cases (9.6%), the age of 45～59 is 17 cases(6.8%) and the age≥60 is 12 cases (4.8%).Course of disease is from 10 days to 40 years,average 60.7 months,<1 year of 72 cases(28.8%),1～3 years of 50 cases (21.6%),> 5 years of 66 cases (26.4%),recorded 8 cases (3.2%) unknown. First routine EEG recorded 30 minutes, and then the results of 24hVEEG monitoring in 250 patients were analysed. Observing monitoring patients if they had clinical seizures, if EEG showed sharp wave, spike wave, sharp-and-slow-wave,or spike-and-slow-wave complex, and these epileptiform discharges and EEG changes before and after attack. Including the results of more than 17-year-old patients with anxiety and depression score.ResultsOf 250 patients, abnormal rate of routine EEG was 9.6%, with epileptiform discharges accounted for 66.7%; abnormal rate of VEEG monitoring was 28.8%, with epileptiform discharges accounted for 75%. Monitored 86 cases of clinical seizures, including the patients of epileptic seizures accounted for 26 cases (30.23%),among them generalized seizure in 8 cases(typical tonic-clonic seizures in 4 cases, typical seizures in 2 cases, myoclonic seizures in 2 cases), simple partial seizures in 12 cases, complex partial seizures in 6 cases,14 cases (53.85%) in NREMⅠ～Ⅱperiod appear attack among the 26 cases of epileptic seizures. The remaining 60 cases (69.77%) are non-epileptic seizures, include:nod,staring,with irregular twitching, Jitter,10 cases; body force, bite, force straight upper and lower limbs stiff with limb shaking,10 cases; the awake state part body twitch,8 cases; paroxysmal syncope,2 cases; paroxysmal fall,2 cases; paroxysmal laugh,4 cases; patients with a transient stupidlyis,4 case; paroxysmal abdominal pain,4 cases; sleep in terror,4 cases; paresthesia, manifested as numbness, coldness,2 cases;sleep systemic limbs irregular twitch,10 cases. Nearly 40% of the patients had anxiety and depression (respectively 34.38% and 37.5%).1 case captured the 1.5Hz of low-medium (<60μv) atypical periodic three-phase wave in early drowsiness, combined with the patient's clinical symptoms was diagnosed probable Creutzfeldt-Jakob Disease (CJD).Conclusion1. VEEG can significantly improve the detection rate of abnormal discharge, especially for epileptiform discharges in epilepsy, and is of great significance in the diagnosis and differential diagnosis of epilepsy and non-epileptic seizure disorders.2. VEEG monitoring may be more conducive to the early periodic three-phase wave, and contribute to the early diagnosis of suspected CJD cases.3. Psychological burden of patients with epilepsy or non-epileptic seizure disorders may be very heavy, and is apt to get the mental illness. Thus it needs comprehensive treatment including psychotherapy in the clinical treatment. |
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