| Objective:To compare the prognostic value of different EEG grading standards of brain function damage in 57 patients with Japanese encephalitis from June 2017 to December 2018,in the Department of Neurology of the Second Affiliated Hospital of Lanzhou University.The most valuable EEG grading standards were selected,and then explore the relationship between the standards and consciousness disorders,epilepsy,and cranial MRI to make a knowledge of the characteristics of EEG in patients with Japanese encephalitis and the mechanism of abnormal EEG.The purpose of this study is to provide some suggestions for the clinical application of EEG in patients with Japanese encephalitis.Methods:57 adult patients with Japanese encephalitis admitted to the Second Hospital of Lanzhou University from June 2017 to December 2018 were analyzed retrospectively.The EEG results,clinical symptoms,cranial MRI and other clinical data of the above patients were collected.The EEG results were classified into four grades:synek,lavizzari,young and clinical.Collecting the mRS score at discharge and one year after discharge,the patients were followed up by telephone.The prognosis was evaluated by Liverpool outcome score(LOS)and then,exploring the relationship between the four classification standards and prognosis to select the most valuable classification standards,to explore the relationship between it and consciousness disorders,cranial MRI,epilepsy.SPSS17.0 was used to process the data.Result:1.There were 57 patients with Japanese encephalitis,40(70.2%)males and 17(29.8%)females.The average age was 44.8±16.87 years.The EEG of 55cases(96%)was abnormal,most of the waves were low,medium and slow,among which 25 cases(43.9%)were mainly?wave,2 cases were?coma,22 cases(38.6%)mainly?activity,10 cases(17.5%)mainly?activity.In 57 patients,34(59.6%)had good short-term prognosis and 23(44%)had poor short-term prognosis.The prognosis of synek and lavizzari was statistically significant(P=0.015;P=0.001).The correlation between EEG and prognosis showed that the EEG classification of synek and lavizzari had a positive correlation with prognosis(P=0.002;P<0.001),and the correlation coefficients were r_s=0.4 and r_s=0.489,respectively.Lavizzari had the highest correlation with short-term prognosis.The prognosis of lavizzari was good and the accuracy of comprehensive prediction was high,which was 77.2%higher than that of synek,but synek had no predictive value(P=0.148).57 patients were followed up by telephone one year after discharge,7 of them were lost.One year after discharge,the Los score showed that 42(84%)patients recovered well,and 8(16%)died or had severe disability.Among the four grading standards,only lavizzari grading standard had statistical difference with prognosis(P=0.045).There was a positive correlation between lavizzari and prognosis(P=0.012),and the correlation coefficient was rs=-0.334.However,the lvizzari electroencephalogram scale had no predictive value for the prognosis after one year(P=0.348).2.Among the 57 patients,19(33.3%)were conscious,9(15.8%)were mild,10(17.5%)were moderate,and 19(33.3%)were severe.There was significant difference between lvizzari EEG grading standard and GSS score(P=0.018).Through the study of the correlation between the lvizzari EEG grading standard and GSS score,it was found that the more serious the consciousness disorder was,the higher the EEG grading standard was(P<0.001),and the correlation coefficient was r_s=0.556.3.In all patients,45(78.9%)had epilepsy,12(21.1%)had no epilepsy,14(24.6%)had partial seizure,7(12.3%)had secondary comprehensive seizure,24(42.3%)had comprehensive seizure.The results showed that there was a significant difference between the severity of EEG and different seizure types(P<0.05).4.The abnormal rate of EEG in 57 patients was 55(96%),and the abnormal rate of cranial MRI was 63.2%,which was far lower than that of EEG.Among the patients with abnormal MRI,12(21.1%)had leukoencephalopathy,19(33.3%)had thalamic lesions,19(33.3%)had basal ganglia lesions,12(21.1%)had hippocampal lesions,11(12%)had brainstem lesions and 11(19.3%)had cerebral cortex lesions.5.By comparing the relationship between the severity of EEG and various lesions,we found that:there was no statistical difference between the abnormal rate of brain MRI of mild EEG and moderate severe EEG(P>0.05),and there was no statistical difference between the severity of EEG and the lesions of white matter,basal ganglia and cerebral cortex(P>0.05);but there was no statistical difference between the severity of EEG and the lesions of thalamus,hippocampus and brain stem(P>0.05)There was significant difference in pathological changes(P<0.05).Conclusions:Lavizzari EEG grading standard can be used to predict the prognosis patients with JE at discharge,but it can not predict the prognosis one year after discharge;lavizzari EEG grading standard is positively relateded to the degree of consciousness disorder,that is,lavizzari EEG grading standard can reflect the degree of consciousness disorder of patients with JE;the severity of lavizzari EEG grading standard can reflect the degree of consciousness disorder;The type of epileptic attack and the classification standard of lavizzari electroencephalogram were moderate to severe abnormal in patients with JE;The changes of hippocampus,thalamus and brainstem were more common in the patients with moderate to severe abnormal EEG. |
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