Continuous EEG Monitoring Study With Supratentorial Large Cerebral Infarction

ObjectivePresently,cerebrovascular diseases are common diseases that threaten the wrinkly and elderly and bring heavy burden on families and society.Massive cerebral infarction is an acute and severe disease in ischemic cerebrovascular diseases that has dreadful disease condition,acute onset,rapid progression,high disability rate and high death rate.It has increasingly been paid attention to by people.EEG monitoring is very sensitive to cortical ischemia and cerebral dysfunction,thus it can directively and sensitively reflect brain function state.The application of electroneurophysiology technology in diagnosis and treatment of massive cerebral infarct ion patients and prognostic evaluation has been paid more and more attention on.EEG monitoring can proceed in continuous and dynamic real time bedside minitoring to evaluate the kinetic reactivity and sleep-wake cicle integrity of cortex function,which has a directive significance for patients' diagnosis,treatment and prognostic evaluation.There are three purposes for this experiment.The first is to explore the value of continuous EEG monitoring for the supratentorial large cerebral infarction.The second is to explore the relation among the prognosis and EEG grading,EEG reactivity and GCS.The third is the diagnosis and forecasting value of continuous EEG monitoring in supratentorial large cerebral infarction patients with epilepsy secondary.MethodsThe paper collects 56 samples of patients onset within 48 hours,who were certified as supratentorial large cerebral infarction by brain CT or MRI check and had lived in NICU of Liaocheng Brain Hospital in the period from Feb,2014 to Dec,2015.The samples include 24 females and 32 males,their ages averaged at 70.36±8.81.The subjects were continuously given EEG monitoring on admittion in 24 hours a day.GCS and EEG evaluation are proceed in the starting and ending periods of monitoring.Further,the quiet and low disturbance for patients hours are chosen.Simulation of ache,sound and light are given to patients respectively to observe their EEG reactivity.Refined EEG grading criteria is applied to grade patients' EEG and record the EEG changes of patients.After 3 months,the patients are followed up for their nerve function recovery and epileptic seizure.The value of continuous EEG monitoring for the supratentorial large cerebral infarction,the relation among the prognosis and EEG grading,EEG reactivity and GCS and the diagnosis and forecasting value in epilepsy secondary are observed.The subjects are all given routine medication which includes anti-platelet aggregation,lipid-lowering,brain metabolism improvement,circulation refinement,free radical clearance and supportive treatment medicine.Results1.The dynamic changing rates of EEG grading,EEG recreativity and GCS are17.85%,8.9% and 3.5% respectively,and the differences have statistical significance.2.EEG grading,EEG recreativity and GCS is relevant with subjects' prognostic evaluation.Their prediction precision rates on patients' prognostic evaluation are 90.60%,83.93% and 80.30% respectively.EEG grading's prediction precision on the prognostic evaluation of supratentorial large cerebral infarction patients exceeds that of GCS,and GCS exceeds that of EEG recreativity.3.Three(5.3%)of the 56 subjects are discovered to have periodical abnormal discharge in their EEG without clinical manifestation of typical seizure attack,but they cannot be excluded from NCS attack or NCSE attack.The follow-up process has witnessed one(1.7%)clinical manifestation of seizure attack.Conclusion1.Continuous EEG monitoring has directive significance for early diagnosis and treatment of supratentorial large cerebral infarction patients.2.EEG grading,EEG recreativity and GCS can be applied to predict the prognostic evaluation of supratentorial large cerebral infarction patients.The higher EEG grades,the worser the prognostic evaluation of patients becomes.EEG with recreativity has better prognostic evaluation than EEG without recreativity.High GCS has better prognostic evaluation than low GCS.3.EEG grading's prediction precision on the prognostic evaluation of supratentorial large cerebral infarction patients exceeds that of GCS,and GCS exceeds that of EEG recreativity.4.The EEG of 56 supratentorial large cerebral infarction patients manifest abnormality where diffuse slow waves and one-side low voltage output EEG are relatively common to see.The cerebral infarction area of some patients has typical epileptic discharge and periodical abnormal discharge,which cannot be excluded from NCS or NCSE.