ObjectiveTo improve the clinicians’ understanding and treatment level of electrical status epilepticus during sleep by analyzing the clinical data of patients with ESES retrospectively.MethodsWe collected 20 cases from 2018 to 2019 diagnosed in our hospital by clinical and 24-hour video EEG confirmed and analyzed the clinical manifestations, EEG features, seizure type, classification of epilepsy syndrome as well as the imaging findings.ResultsAmong the 20 patients, there were 12 males and 8 females, the mean age was (10.96±2.68) years old, and the first onset age was (8.90±1.93) years old. Epilepsy seizure as the first symptom is most common, the EEG showed a broad or localized sustained discharge, generalized tonic clonic seizure is the main form of seizure type in most patients, ECSWS is the most prominent in the epilepsy syndrome, for small lesion through MR can be found early.ConclusionMost patients have partial or generalized seizures, which have a range of cognitive impairment, mental decline or other issues. It is important to improve the cognitive function, behavior, neuropsychology of patients by long term video EEG monitoring in the early stage.
ObjectiveThe purpose of this study was to compare the value of SEEG and subdural cortical electrodes monitoring in preoperative evaluation of epileptogenic zone. MethodsFeatures of patients using SEEG (48 cases) and subdural cortical electrodes monitoring (52 cases) to evaluate the epileptogenic zone were collected from June 2011 to June 2015. And the evaluation results, surgical effects and complications were compared. ResultsThere was no significant difference between SEEG and subdural cortical electrodes monitoring in identifying the epileptogenic zone or taking epileptic surgery, but SEEG could monitor multifocal and bilateral epileptogenic zone. And there was no significant difference in postoperative seizure control and intelligence improvement (P > 0.05). The total complication rate of SEEG was lower than subdural cortical electrodes monitoring, especially in hemorrhage and infection (P < 0.05). ConclusionsThere was no difference among SEEG and subdural cortical electrodes monitoring in surgical results, but SEEG with less hemorrhagic and infectious risks. SEEG is a safe and effective intracranial monitoring method, which can be widely used.
ObjectiveTo explore the clinical and video EEG features of patients with post-stroke epilepsy (PSE).MethodsThe clinical data of 68 patients with epilepsy after cerebral infarction and 33 patients with epilepsy after cerebral hemorrhage were analyzed retrospectively from January 2015 to June 2018 in the Affilated Hospital of Jining Medical University. There were 5 cases of early-onset epilepsy, and the rest were late-onset epilepsy. There were 68 cases of cerebral infarction (1 case showed post-infarction hemorrhagic transformation), 33 cases of cerebral hemorrhage; 51 females, 50 males (f∶m = 1.02∶1); the onset age was 45 ~ 101 years, with an average of (68.10 ± 10.26) years.ResultsThe time from seizure to stroke in 101 cases was (28.92 ± 35.61) months, 60 cases (59.40%) ≤ 1 year, 26 cases (25.74%) 1 ~ 5 years, and 15 cases (14.85%) 5 ~ 10 years. Post-stroke epilepsy had no relation to gender (P>0.05). The age of onset is mostly in 60 to 75 years old (62.38%). Seizure often happen within 1 year after stroke (59.4%). The type of attack is focal seizure (77.23%). Cortical infarction (77.94%), cerebral artery stenosis (83.82%), hypertension, diabetes, and atrial fibrillation are risk factors for epilepsy after infarction. The abnormal rate of EEG for PSE is 90.1%, which was manifested as slow wave in the lesion side, epileptic wave in the lesion side or contralateral side.ConclusionsThe location, duration, age and severity of cerebral artery stenosis in patients with PSE are closely related to the occurrence of seizure. VEEG plays an important role in the diagnosis, treatment and prognosis of epilepsy.
ObjectiveTo explore the technique of preoperative evaluation of video electroencephalography (VEEG) electrode fixation method.MethodsThe electrode fixation method was modified using a simple and easy-to-manufacture 3M decompression sticker designed by ourselves.ResultsUsing the modified electrode fixation method, compared with the traditional fixation method, the electrode displacement, shedding rate and pain score of the children were significantly lower (P<0.05). The incidence of skin pressure sore by traditional fixation method was 7.03%. The rate of improvement after release was 3.37%. Although it was not statistically significant, the incidence of pressure ulcers were reduced.ConclusionsEffectively reduce the adverse reactions such as electrode displacement, shedding, pain and skin pressure sore caused by wearing the electrode for a long time. It has the advantages of being simple, fast, safe, stable and humanized, and it is worthy of clinical promotion.
ObjectiveAicardi and Goutières syndrome was first reported as a rare hereditary encephalopathy with white matter involvement in 1984. Typical clinical manifestations include severe mental motor development retardation or regression, pyramidal and extrapyramidal symptoms and signs, epilepsy, microcephaly and frostbite.MethodsTo collect a case of patient who presented with convulsions 14 days after birth without obvious inducement. The child was diagnosed as epilepsy in the local hospital and the symptoms improved after treatment with antiepileptic drugs. At 4 months, the child presented nods and clenched fists, and was diagnosed as infantile spasm. After Adrenocorticotrophic hormone and drug treatment, the symptoms gradually improved. Due to upper respiratory track infection, the child was aggravated at the age of 1 year and 2 months, and then diagnosed as Aicardi-Goutières syndrome by video EEG, skull MRI, fundus and gene screening.ResultsSurgery and treatment with antiepileptic drugs significantly improved the symptoms of the child, and the pathological biopsy of the brain tissue supported the previous diagnosis.ConclusionsThe report of this case will help to improve the clinician's diagnosis and treatment of Aicardi-Goutières syndrome.
ObjectiveThe purpose of this study was to investigate the autoimmune encephalitis (AE) seizure types and EEG characteristics and the value of diagnosis. MethodsFifteen AE patients were hospitalized in the Department of Neurology at the First Hospital of Jilin University from November 2012 to July 2014. Data from their clinical manifestations, seizure types, EEG characteristics and laboratory investigation were analyzed. ResultA total of 15 patients, 5 males and 10 females, aged 19-75 years were included. Eight cases of anti-NMDA receptor encephalitis, five cases of LGI1 receptor encephalitis and two cases of anti-Hu antibody encephalitis were diagnosed clinically.①Anti-NMDA receptor encephalitis:seven patients had seizures, which inclued complex partial seizure, generalized tonic-clonic seizure, simple partial seizure and status epilepticus.Three patients had extreme delta brush.②LGI1 receptor encephalitis:two cases had seizures, while four cases with FBDS. Sharp and slow waves with irregular delta waves appeared in bilateral temporal areas in EEG of three cases, while one case showed clinical seizure. Two cases detected "limb shaking and others" attack, but the corresponding EEG showed no abnormalities.③Anti-Hu antibody encephalitis:one case showed seizures, the EEG showed a lot of sharp and slow waves with irregular delta waves in bilateral temporal areas, while one case showed sharp and slow waves. ConclusionAnti-NMDA receptor encephalitis can present with various types of seizures and non-convulsive status epilepticus, interictal extreme delta brush is more specific. It has important value. LGI1 receptor encephalitis is characterized by FBDS, it has important clinical significance.Anti-Hu antibody encephalitis lesions diffuse distribution, clinical manifestations are different. It may be associated with seizures, seizure types are not-specific.It may have slow waves or sharp and slow waves.
Objective To investigate the clinical and EEG characteristics, therapeutic response and prognosis in children with atypical absence seizures. Methods The clinical and EEG data of 43 children with atypical absence seizures in Qilu Hospital, Shandong University during January 2011 to December 2016 were analyzed, and therapeutic response and prognosis were followed up. Results Childre were 24 male and 19 female with the mean age of 5.43 y. The onset ages were from 1 years and 8 months to 10 years and 3 months. All of the 43 patients had MRI examines, and 18 children were normol. MRI abnormalities appeared in 25 children, including cerebral cortical dysplasia and cerebral atrophy (13 cases), congenital corpus callosum hypoplasia (2 cases), and abnormal signal in bilateral posterior putamen (2 cases), encephalomalacia focus(4 cases), ventricle expention (2 cases), hydrocephalus(2 cases). All the children underwent EEG more than once. All children had atypical absence seizures during daytime. Children had slowly backgrounds in retesting EEG, and spine and slow waves of 1.5 Hz to 2.8 Hz could be seen in all the atypical absence seizures. All children were followed up, and except 6 children with complete control, 19 children’ parents reported seizure- free, 18 children have poor effect. Forty Children had various degrees of psychological abnormalities and motor regression. Among them 13 cases had psychological abnormalities and motor regression before disease; cognitive ability of 27 cases were normal before onset age, however, about 75% to 95% of the children became abnormal 2 years after atypical absence seizures. The rest 3 cases had no obviously impairment. Conclusions Most of the atypical absence seizures children had small onset age and high incidence in mental damage and cognitive impairment. The course of typical absence seizures aggravate gradually, and often develops to nonspecific brain damage in this process. Antiepileptic drugs can reduce the frequency of the seizure in part of the patients, but had no effect on psychological and motor regression.
ObjectiveTo explore the clinical value of SEEG-guided radiofrequency thermocoagulation therapy in patients with posterior cortex epilepsy.MethodsA case of epilepsy secondary to viral encephalitis was reported in this paper, SEEG implantation confirmed that the seizure began in bilateral posterior head, and the right posterior head was the main area of disabling lesion. After a series of complete preoperative neuropsychological assessment, the right posterior head was found to have functional retention. Therefore, we used a minimally invasive radiofrequency thermocoagulation therapy to damage epileptic foci.ResultsThe patient were followed up for 2 years after operation, the seizure frequency were significantly reduced, and the patients did not show symptoms of functional loss.ConclusionPosterior cortex epilepsy is common in neonates with brain injury. The localization and lateralization of operation is difficult because its EEG showed bilateral discharges, or the seizures start from both sides of posterior head, meanwhile, posterior head involves functional areas, which makes the operation even more difficult. This minimally invasive treatment destroys the lesion and maximizes the protection of the patient's functional areas, which provides a new surgical approach for bilateral posterior cortex epilepsy in the future, especially for symptomatic epilepsy caused by hypoxic-ischemic brain injury and encephalitis.
Electric and electronic products are required to pass through the certification on electrical safety performance before entering into the market in order to reduce electrical shock and electrical fire so as to protect the safety of people and property. The leakage current is the most important factor in testing the electrical safety performance and the test theory is based on the perception current effect and threshold. The traditional method testing the current threshold for perception only depends on the sensing of the human body and is affected by psychological factors. Some authors filter the effect of subjective sensation by using physiological and psychological statistical algorithm in recent years and the reliability and consistency of the experiment data are improved. We established an experiment system of testing the human body's current threshold for perception based on EEG feature analysis, and obtained 967 groups of data. We used wavelet packet analysis to detect α wave from EEG, and used FFT to do spectral analysis on α wave before and after the current flew through the human body. The study has shown that about 97.72% α wave energy changes significantly when electrical stimulation occurs. It is well proved that when the EEG feature identification is applied to test the human body current threshold for perception, and meanwhile α wave energy change and human body sensing are used together to confirm if the current flowing through the human body reaches the perception threshold, the measurement of the human body current threshold for perception could be carried out objectively and accurately.
It is an important means to study the electrical activity of the brain's nerve cells by exploring physiological information of the EEGs from the frequency domain. The gravity frequency is one of the global parameters with using this method. We used the multitaper spectrum method (MTM) spectrum estimation method of good performance to calculate the EEG spectrum and its gravity frequency of subjects under vigilance and vigilance decrement state. The results showed that the gravity frequency of vigilance state was higher than that of vigilance decrement state, the gravity frequency became smaller along with the vigilance decrement, and the location of the gravity frequency shifted to the left in the spectrum. Finally, the monitoring curve of the gravity frequency was acquired by designing an algorithm, and it was used to online monitoring vigilance operators.