| Part 1 The Predictive Value of Interictal Epileptiform Discharges in the Recurrent Risk of Epilepsy with Withdrawing the Antiepileptic DrugsObjectiveThis paper is designed to explore and research the relapsing risk of influence of interictal epileptiform discharges(IEDs)on patients with withdrawing the antiepileptic drugs(AEDs).MethodsA total of 100 epilepsy patients who had been diagnosed and treated in Neurology Department of PLA General Hospital for more than 2 years from July 2015 to July 2016 were divided into two groups according to the presence or absence of IEDs,namely,IEDs group(51 cases)and no IEDs group(49 cases).According to operational classification of seizure types by the International League Against Epilepsy(ILAE)introduced in 2017,the patients were divided into several groups,namely generalized onset(tonic-clonic,myoclonic,typical absence)groups,focal onset(aware,impaired awareness)groups and>2 seizure types group.All patients were followed up for at least 1 year,and followed by outpatient visits or telephone follow-up.Results:In 100 epileptic patients,different types of seizure are compared to each other.The incidence of IEDs in patients with myoclonic,complex partial seizures,and patients with two or more types of seizures was significantly higher than that of patients with tonic-clonic,absence,and simple partial seizures,the difference was statistically significant(P<0.05).37 cases of epileptic relapse were found in IEDs group(72.5%),16 cases of epilepsy relapsed in no IEDs group(32.7%).Logistic regression analysis showed that the duration of disease(P=0.022,OR:1.165,95%CI:1.022-1.329)and IEDs(P=0.042,OR:2.794,95%CI:1.040-7.509)may be the risk factors for the relapse of epilepsy after withdrawal of AEDs.Conclusions:The type of seizure and the duration of disease may have predictive value and clinical significance for the long-term epileptic seizure-free patients who will relapse or not after withdrawal of AEDs.Part 2 The Electroencephalogram in Comorbidity of Epilepsy and Migraine-Significance of Intermittent Theta RhythmObjectiveThis paper is designed to explore and analyze the diagnostic value and clinical significance of intermittent theta rhythm in patients with epilepsy and migraine.MethodsFrom July 2014 to December 2017,222 cases of patients with migraine,121 cases of patients with epilepsy and 101 cases of comorbidity of epilepsy and migraine patients were served as the clinical research objects,and examined by a headache scale,then the patients with migraine and comorbidity of epilepsy and migraine were divided into three groups with classification of migraine according to the third edition of International Classification of Headache Disorders(ICHD-Ⅲ)introduced in 2013,namely,migraine without aura group and migraine with aura group.All subjects were examined by EEG and divided into two groups according to headache attack or not during examination,namely,attack group and interictal group,then analyze the occurrence of intermittent theta rhythm of each group according EEG.Results:The incidence of intermittent theta rhythms in migraine patients(62.2%vs43.5%,P=0.008)and patients with epilepsy and migraine(81.3%vs54.7%,P=0.009)was higher in the attack than that in the interictal period.The general(ictal/interictal)incidence of intermittent theta rhythm in migraine with aura group was higher than that in migraine without aura group(78.8%vs 49.4%,P<0.001),and that in the patients with epilepsy and migraine was higher than that in migraine(67.3%vs 51.8%,P=0.013)and epileptic(67.3%vs 43.8%,P=0.001)patients.In the attack,the incidence of intermittent theta rhythm in comorbidity of epilepsy and migraine was higher than that of migraine(81.3%vs62.2%,P=0.033),but not in the interictal period(P=0.117).The incidence of intermittent theta rhythms in patients with migraine,epilepsy,comorbidity of epilepsy and migraine in all age groups had no significant difference.Logistic regression analysis showed that migraine in attack(P<0.001,OR:2.712,95%CI:1.670-4.402),the migraine with aura(P<0.001,OR:4.528,95%CI:2.437-8.415)and the comorbidity of epilepsy and migraine(P=0.003,OR:1.481,95%CI:1.139-1.926)were all influence factors for intermittent theta rhythm.Conclusions:The incidence of intermittent theta rhythms is higher in migraine in attack,the migraine with aura and comorbidity of epilepsy and migraine.It may be related to the possible pathophysiological mechanism of CSD,which may be associated with high incidence of epilepsy and migraine comorbidity. |
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