The Comparative Study Of The Clinical Significance Of Routine Electroencephalogram And 24 Hours Ambulatory Electroencephalogram Examination In The Diagnosis And Treatment Of Epilepsy

BackgroundEpilepsy is a group of disorders of the brain that can cause sudden abnormal excessive synchronization discharge and also can cause clinical epileptic seizures. At present, the preferred way to control the Seizures is still drug treatment. But the effect of drug therapy is difficult to objectively judge only by the observation of the patients or their families alone. Electroencephalogram is very important to the diagnosis, classification, selection of antiepileptic drugs of epilepsy as an objective examination of capturing sample epilepsy wave. The literatures report the epileptic discharge detection rate of 24 hours Ambulatory Electroencephalogram (24hAEEG) is much higher than that of Routine Electroenceph -alogram(REEG). Whether repeating 24hAEEG examination can also improve the epileptic discharge detection rate of 24hAEEG of epilepsy patients and whether the results of regular 24hAEEG examination or REEG are consistent with the effect of drug therapy by cinical observation, few literatures at home and abroad report at present.Objectives1. To compare the difference of the epileptic discharge detection rate of 24hAEEG and REEG examination in clinical diagnosis epilepsy Patients.2. To compare the difference of the epileptic discharge detection rate by once 24hAEEG and twice 24hAEEG examination in clinical diagnosis epilepsy Patients.3. To compare the difference of the consistency of the results of 24hAEEG and REEG examination with the clinical drug therapy effect during the regular antiepileptic drug treatmentMethods1. Select 210 cases of patients which comply with the standard patients into the group from the 1850 epilepsy patients in North He Nan who were done a diagnosis and given treatment by the second affiliated hospital of xinxiang medical college Neurology Department and divided into REEG group and 24hAEEG group according to the differences of conducting REEG examination and 24hAEEG examination in the process regular follow up.2.24hAEEG examination adopts eight leading portable AEEG from U.S. TaiKang medical systems Co,Ltd. Fix electrode with collodion according to the 10/20 international electrical system. Then,let the patient take the holter record box away and take the holter record box back after 24 hours, then input data into the main engine.REEG examination adopts sixteen leading portable AEEG from Nan Jing Weishi company.Fix electrode with collodion according to the 10/20 international electrical system and add hyperventilation and flash trigger test when necessary.3. Grouping:(1) REEG group:checked out sample epilepsy wave by REEG examination or 24hAEEG examination and conduct formal antiepileptic therapy. Subsequent visit every three months and conduct REEG examination every three months too, together four times REEG examinations every year.(2) 24hAEEG group:checked out sample epilepsy wave by REEG examination or 24hAEEG examination and conduct formal antiepileptic therapy. Subsequent visit every three months and conduct 24hAEEG examination once a year.4. Apply spss20.0 statistical software to establish the database and statistical analysis and enumeration data use chi-square examination. The diffirence of statistical analysis was statistical significant when P<0.05.Results1. Among the clinical diagnosis epilepsy patients, the epileptic discharge detection rate of REEG is 39.0%, once 24hAEEG is 78.6%, twice 24hAEEG is 92.4%, there were significantly statistical diffirences (P<0.01).2. The consistent rate of the result of REEG and clinical curative effect is 81.5%(75/92) for the first year of follow-up and 85.9%(79/92) for the second year while the inconsistent rate is 18.5%(17/92) for the first year,14.1%(13/92) for the second; The consistent rate of 24hAEEG is 62.1%(59/95) for the first year,70.5%(67/95) for the second while the inconsistent rate is 37.9%(36/95) for the first year,29.5%(28/95) for the second. there were no statistical diffirences (P>0.05). Among the inconsistent rate, 89.3%～94.5% is the clinical seizure controlled or improved but the result of 24hAEEG not improved.3. The proportion of normal REEG result with controlled clinical seizures was much higher than that of 24hAEEG while the proportion of none-improved REEG result with controlled or improved clinical seizures was much lower than that of 24hAEEG,The relationship between the result of regular 24hAEEG examination and the effect of drug therapy by cinical observation and The relationship between the result of regular REEG examination and the effect of drug therapy by cinical observation had statistical diffirences (P<0.01).Conclusions1.The epileptic discharge detection rate of 24 hours Ambulatory Electroenceph-alogram (24hAEEG) is much higher than that of Routine Electroencephalogram(REEG) and repeating 24hAEEG examination can also improve the epileptic discharge detection rate of epilepsy patients,2. the results of regular 24hAEEG examination or REEG are not completely consistent with the clinical curative effect. Regular 24hAEEG examinations are more valuable in judging of clinical curative effect.