部分性癫痫患者的定量脑电图和P300研究

摘要

目的:用定量脑电图、事件相关电位P300的方法评价部分性癫痫患者的脑功能障碍.方法:用W值代表脑内慢快波成份的相对功率比例,反映大脑局部皮层功能障碍.观察左侧、右侧部分性癫痫患者的发作间期脑电图的W值差异和事件相关电位P300的潜伏期、波幅、反应时等指标的组间差异,并与对照组比较.结果:右侧部分性癫痫组F8、T4 T6区的W值显著高于左侧部分性癫痫组,左侧部分性癫痫组T3、O1区的W值显著高于右侧部分性癫痫组,两者比较差异均有统计学意义(P＜0.05).病程大于5年组T6区的W值高于病程小于1年组和病程1～5年组,病程大于5年组O2区的W值高于病程1～5年组,两者比较差异有统计学意义(P＜0.05).部分性癫痫组P300总的异常率为54.76％,左侧、右侧部分性癫痫组P300异常率分别为77.78％和37.50％,两者比较差异均有统计学意义(P＜0.05)；左侧部分性癫痫组CZ、Pz点波幅显著低于右侧部分性癫痫组和对照组(P＜0.05)；左侧、右侧部分性癫痫组Cz及Pz点潜伏期、反应时较对照组显著延长(P＜0.05),但左侧与右侧部分性癫痫组间无统计学差异.结论:部分性癫痫引起致痫灶同侧的大脑皮层功能障碍,其严重程度与病程有关；而且左侧部分性癫痫患者比右侧部分性癫痫患者的大脑功能障碍更明显.%Objective:Quantitative EEG and event-related potential P300 were used to evaluate impairment of cerebral function in patient with partial epilepsy.Methods:W value was calculated (power of EEG δ and θ rhythm divided by power of α and β rhythm) for the extent of focal cortical dysfunction.The W values in left partial epilepsy group,right partial epilepsy group and control group during interictal period were compared.The latency,amplitude and reaction time of P300 potential change were observed in each group.Results:The W values in Fs,T4 and T6 regions in patients with right partial epilepsy were higher than those in patients with left partial epilepsy(P ＜0.05).The W values in T3,O1 regions of patients with left partial epilepsy were higher than those in patients with right partial epilepsy(P ＜0.05).Furthermore,the W value in T6regions of patients with a disease course longer than 5y was significantly higher than that of patients with a disease course 1-Sy or less than 1y; the W value in O2 regions of patients with a disease course longer than 5y was significantly higher than that of patients with a disease course between 1-Sy (P ＜ 0.05).In patients with right or left partial epilepsy,the total abnormal rate of P300 was 54.76％,the latency,amplitude and reaction time were significantly different to the control group.The abnormal rate of P300 in left and right partial epilepsy groups were 77.78％ and 37.50％,respectively,and the former is significantly higher than the latter.The amplitudes of P300 in Cz and PZ of left partial epilepsy were significantly lower than those of right partial epilepsy and control group (P ＜0.05).The latency and reaction time of P300 in Cz and Pzof all partial epilepsy were significantly longer than those of control group (P ＜ 0.05),however,no difference was found between left and right partial epilepsy.Conclusion:In partial epilepsy the cortical dysfunction occurs ipsilaterally to the epileptogenic zone,and extent of cortical dysfunction is positively correlated with duration of disease course.Cerebral dysfunction in left partial epilepsy is more severe than that in right partial epilepsy.