| Objective To investigate the types of paroxysmal diseases in xizang and identify the types of paroxysmal diseases that need to be monitored by video eeg.To analyze the clinical characteristics of patients with common seizures,i.e.epileptic seizures and psychogenic non-epileptic seizures.The effects of high altitude,high altitude and high hemoglobin on epileptic seizures were analyzed.According to theclinical characteristics of epileptic seizures,the risk rate of epileptic seizures was predicted in patients with cerebral cortex lesions after cerebrovascular accident and cysticercosis,so as to guide the clinical prognosis.This paper summarizes the semiotic characteristics of psychogenic non-epileptic seizures in xizang,and provides more evidence to distinguish them from epilepsy.Method 1.Clinical data: In accordance with the requirements of the medical ethics and achieve the object of study under the premise of informed consent,on the basis of this study and formulate relevant standards(inclusion criteria and exclusion criteria),in 2013 to 2018 retrospectively neurology clinic in the Tibet autonomous region people's hospital during the period of 600 patients with a seizure disorder,and complete video eeg monitoring.2.Relevant diagnostic criteria in this study: the definition of paracentesis is according to the definition mentioned by fanger [1] and Stafstrom CE [2] in relevant reports;Epilepsy diagnosis refers to the diagnostic criteria of neurology [3];The eeg diagnostic criteria were analyzed according to the clinical electroencephalography edited by liu xiaoyan [4].Psychogenic non-epileptic seizures refer to the clues in the diagnosis of PNES seizures [5] and the level of certainty in the diagnosis of PNES proposed by the international anti-epileptic alliance(ILAE)[6].3.Statistical methods: SPSS 23.0 statistical software was used for statistical analysis.The counting data were expressed by 100% and analyzed by chi-square test.Binomial Logistic regression was used for multivariate analysis.The measurement data is represented by (?)ąS.Results In video electroencephalogram(eeg)monitoring in 600 cases of a seizure disorder,with epileptiform sample abnormal discharge in 171 cases(28.50%),video electroencephalogram(eeg)between the episodes and(or)attack period to monitor the abnormal discharge,characterized by diffuse or focal epileptiform abnormalities,including epilepsy diagnosis significance of video eeg monitoring results of 143 cases(23.83%).At present,there are 29 types of seizure diseases in Tibet that need to be identified by video eeg monitoring.The main types of seizure are epilepsy,psychogenic non-epileptic seizure,epileptic seizure,syncope and so on.The main types of seizures,such as epileptic seizures,psychogenic non-epileptic seizures,epileptic seizures,and syncope,have significant predisposing factors or prodromal manifestations prior to the onset.Gender,duration of seizures,frequency of seizures,and imaging findings suggested that there were statistically significant differences in cortical lesions between the epileptic seizure group and the non-epileptic seizure group(P < 0.05).In the multivariate binomial logistic analysis,gender,cortical lesions,seizure frequency,pathogenesis and residence altitude were the independent influencing factors of epileptic seizures.Males were more significant in epileptic seizures than females,and the risk of epileptic seizures in females was 0.416 times higher than that in males(P < 0.05,OR=0.416).Those with lesions in the cortex had a12.674 fold increased risk of seizure compared with those without(P < 0.05,OR=12.674).The more frequent the seizures,the higher the risk of recurrence(P <0.05,OR=1.636).The longer the course of seizure,the higher the risk of relapse was2.509 times(P < 0.05,OR=2.509).There was a positive correlation between thealtitude of the patient's residence and the epileptic seizure(regression coefficient=0.001).For each unit of altitude increased,the risk was reduced by 1.001 times(P <0.05,OR=1.001).Stroke was the main factor of secondary epilepsy(32.69%).Stroke is also the main cause of epilepsy in young people,followed by cysticercosis.In all age groups,female patients with psychogenic non-epileptic seizures are higher than men,and male and female patients with psychogenic non-epileptic seizures are mainly distributed in the young.Multivariate binomial logistic analysis of the risk factors for psychogenic non-epileptic seizures showed that education level and gender were independent risk factors for psychogenic non-epileptic seizures.The level of education can significantly affect the occurrence of psychogenic non-epileptic seizures,and the level of education of patients with psychogenic non-epileptic seizures is lower than that of patients with other types of seizures.Psychogenic non-epileptic seizures were different between male and female,and the risk of female was 1.796 times that of male(P < 0.05,OR=-1.796).In the semiotic study of psychogenic non-epileptic seizures,the most common symptom was limb shaking,accounting for 63.64% in males and 54.76% in females.It according to the various characteristics of semiotics is divided into four types,the most common type of systemic movement,and male 12cases(54.55%),42 cases(50.00%),various types of attacks on differences between men's and women's gender has no statistical significance(P > 0.05),the minor groups and youth attack types,their differences had no statistical significance(P > 0.05).Conclusion 1.There are many kinds of diseases similar to seizures and seizures in Tibet,and these diseases need to be monitored by video eeg.2.A small number ofvideo eeg monitoring found epileptic waveform,not diagnosed with epilepsy patients need a long-term follow-up for epileptic seizures.3.In Tibetan areas,high altitude will increase the risk of epilepsy.In the environment of high altitude and low oxygen,the risk of epilepsy will also increase in those with lesions in the intracranial cerebral cortex.4.If a seizure is not treated early,the risk of recurrence increases with the duration of the seizure.5.Video eeg monitoring remains the gold standard for distinguishing epileptic seizures from non-epileptic seizures.6.Psychogenic non-epileptic seizures are related to educational level and gender.Young women and those with lower educational level are prone to them. |
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