脑电图在病毒性脑炎早期诊断及预测预后的应用价值

摘要

Objective To investigate the value of the EEG in the early diagnosis and prognosis of viral encephalitis. Methods We studied 76 patients admitted to our hospital with viral encephalitis.In the first week, we routain did EEG、Cerebrospinal fluid(CSF) and brain magnetic resonance imaging(MRI),the abnormal rate for diagnosis of viral encephalitis were compared. After 3 months,we followed up and reviewed EEG,EEG showed slow wave or localized seizure wave or clinical symptoms were headache,seizures,unresponsive,disease progression was not improved group,no clinical symptoms and check EEG was normal or borderline EEG was improved group. Results Normal EEG 8 cases, abnormal in 68 cases (mild abnormality in 36 cases,moderate abnormality in 27 cases, severe abnormalities in 5 cases), CSF was abnormal in 45 cases, 20 cases of abnormal brain MRI. The abnormal rate of EEG in diagnosis of viral encephalitis is higher than that of cerebrospinal fluid and brain MRI. After 3 months of follow-up, mild, moderate, severe abnormal EEG were 2 cases, 4 cases, 3 patients did not improve respectively,and all severe patients had severe abnormalities in patients with EEG. As the EEG in patients with abnormal degree increased, patients after 3 months no improvement rate increased.Conclusion EEG abnormal rate in virus encephalitis is higher than CSF and brain MRI, can be used for early diagnosis. There is high consistency in virus encephalitis, the abnormal electrical activity in the brain change and the clinical prognosis, which can be used to guide the clinical.%目的：探讨脑电图（EEG）在病毒性脑炎早期诊断及预测预后的价值。方法对76例病毒性脑炎的患者，比较EEG、脑脊液、头颅MRI检查诊断病毒性脑炎的异常率。发病3个月后复查EEG并随访，EEG有慢波或局限性痫性发作波或临床症状有头痛、抽搐、反应迟钝者、病情恶化者归为未好转组，无临床症状且复查EEG为正常或界限性EEG者归为好转组。结果76例病毒性正常EEG8例，异常68例（轻度异常36例，中度异常27例，重度异常5例），脑脊液检查异常45例，头颅MRI异常20例。EEG诊断病毒性脑炎的异常率高于脑脊液及头颅MRI。3个月后随访，轻、中、重度异常EEG患者分别有2例、4例、3例患者未好转，且3例临床重症患者均为重度异常EEG患者。随着患者脑电图检查异常程度增高，患者3月后未好转率有增高的趋势。结论病毒性脑炎脑电图异常率高于脑脊液和头颅MRI，可为早期诊断提供依据。病毒性脑炎异常脑电活动改变程度与临床预后有较高的一致性，可用于指导临床。