| ObjectiveTo explore the application of electroencephalogram(EEG) in the diagnosis and treatment of diffuse axonal injury(DAI)in children, provide reference for the injury severity evaluation,prognosis judgement, mental retardation and seizure at later stage, assist clinical therapy and improve the patient’s quality of life.Materials and Method111 cases of children with diffuse axonal injury from July 2013 to September 2015 in our hospital were collected, including GCS score at the time of admission to hospital and primary coma time after injury was applied to classify the severity, the abnormal EEG of three different periods(≤1 week post-injury,2 weeks to 1 months post-injury,3 months to1 year post-injury), follow-up results of the Glasgow outcome scale(GOS)score, Gesell developmental scale of 0-4 years old infants used to measure Development quotient(DQ) and Wechsler intelligence test results of 4.5-16 years old children used to measure Intelligencequotient(IQ).Correlation test was used to analyze the relativity and rank sum test was used to analyze the difference between two of the above date.Results1. Of 111 cases of children with DAI, 12 cases were light, 23 cases were moderate, 57 cases were severe, 19 cases were extra severe. Prognosis:32 cases restored well: 46 cases had mild disability; 25 cases had severe disabilities, 3 cases were temporary plant survival( < 1 month) and 4cases were persistent plant survival(≥1 month), 1 case was dead.2. There was a positive correlation between the severity of DAI and the severity of the acute phase EEG abnormal degree.3. There were differences in the degree of EEG abnormality in different periods. In the acute stage, moderate abnormal EEG was predominated,in the recovery period was mild abnormal EEG, and in follow-up period was mild abnormal and normal EEG.4. There was a negative correlation between the degree of EEG abnormality in three different stages and the prognosis of DAI in children.5. 42 cases were tested with Wechsler intelligence test, among them 6cases reached normal level, 12 cases horizontal edges, 8 cases mild low,12 cases moderate low and 4 cases severe low; 17 cases were tested with Gesell developmental scale, among them 11 cases mild low,3cases moderate low and 3 cases severe low, no normal level or horizontal edges.6. There was a positive correlation between the abnormal degree of EEG and the Wechsler intelligence test scores in the recovery period, there was irrelevant relationship between them in both acute and follow-up periods.7. There was a positive correlation between the abnormal degree of EEG and the Gesell developmental scale in the follow-up period,there was irrelevant relationship between them in both acute and recovery periods.8. There was a positive correlation between the severity of DAI and the occurrence of epileptiform discharges showed on the EEG.Conclusion1. The heavier the DAI severity is, the higher the degree of EEG abnormality in the acute stage is.2. EEG abnormal rate is high at acute stage. With recovery, the change of EEG tends to be normal or improvement at any period. Abnormal degree of EEG could indicate the prognosis, the higher abnormal degree is, the worse the prognosis is. The persistence of EEG abnormalities often indicates a poor prognosis.3. For elderly children,the heavier degree of abnormal EEG during the recovery period is, the more serious the mental retardation occur.During the acute period or the follow-up period, the degree of EEG abnormality is not relevant with the mental retardation in children with DAI. However,for the infants,the heavier degree of abnormal EEG during the follow-up period is, the more serious the mental retardation occur.4. The occurrence of post-traumatic epilepsy in children with DAI is related to the severity of the injury. The more serious the injury is, the more prone the post-traumatic epilepsy to occur. Tested by EEG could discover subclinical seizures and the abnormal events of non-epileptic seizures. |
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