The Clinical Study Of Long Term Video EEG Monitoring In The Diagnosis Of Epilepsy

Background: epilepsy is the second most common chronic disease of nervous system, commonly known as "Yangjiaofeng", a serious threat to people's life and health. Domestic overall prevalence is about7 ‰.The etiology of epilepsy is complex and varied, which seriously influence the patients' physical and mental health as well as the quality of life. Epidemiological data show that China currently exist about 9 million patients and patients with an annual increase of 400000 to 600000. Due to the short seizures duration,it is difficult to diagnosis, clinicians are hard to witness the onset condition of each patient. so long-range video EEG can be observed simultaneously with epilepsy onset of clinical manifestation and EEG change,it can be accurately in epilepsy diagnosis, differential diagnosis and classification of seizure type. At the same time it also provides the reliable basis for epilepsy surgery preoperative assessment. Video EEG monitoring results provide strong evidence for clinical anti-epileptic drug selection and reasonable adjustment of subsequent drugs. Meanwhile it plays an irreplaceable role in non-epileptic seizure identification. It has important decision value in the diagnosis and differential diagnosis of paroxysmal diseases.Objective: To evaluate the diagnostic value of epilepsy seizure by means of long-term video EEG monitoring,improving the diagnosis of epilepsy and related syndromes and providing accurate decision-making tools for rational clinical application of this technique.At the same time, we discuss the clinical manifestations, EEG features, imaging characteristics and analysis antiepileptic drug efficiency of 273 cases with TLE and conduct follow-up studies, providing the reference for clinical diagnosis and treatment of TLE.Method: Using the strict inclusion criteria,from January 2012 to January 2015 in our hospital department of neurology,outpatient and inpatient patients for the first time in a seizure disorder for different range EEG monitoring,the EEG data were analyzed retrospectively. While selecting 273 cases diagnosed with TLE with long-term video EEG monitoring in Xi Jing hospital from January 2013 to December 2014 as the research object, the clinical data were analyzed, gathering the information of patients and followed-up by telephone. To explore the clinical related factors of TLE and assess the curative effect of antiepileptic drugs.Results: In 24 hours group,video EEG monitoring showed that abnormal discharge has the highest positive rate in 76.9%.In 1920 cases,1476 cases had abnormal discharge,287 cases were recorded clinical seizure, specifically seizure type 153 cases,96 cases to further defined as the epilepsy syndrome. The long range video EEG monitoring is more accurate in the diagnosis, classification and seizure type.247 of 273 patients with TLE has abnormalities in long-term video EEG,sleep stage discharge is significantly higher than awake Imaging has changed in 166 cases, accounting for60.8% of the total number of patients. Hippocampal sclerosis or degeneration,temporal lobe encephalomalacia,temporal arachnoid cyst are common change,the peak age of onset is 19-39 years old. AEDs overall seizure-free rate is 68.5%, the effect is remarkable Wherein monotherapy seizure-free rate accounted for 67.1%, two drugs treatment without attack rate accounted for 70.8%,two treatments by ?2 test,the difference was not statistically significant(P = 0.776, P> 0.05).Conclusion:24-hours video EEG monitoring can significantly reduce the false negative and false positive rate, eliminate interference effectively. improving the positive rate of patients with epilepsy. It has important auxiliary diagnosis value in the diagnosis of epilepsy, classification, lesion location, the judgment of drug curative effect and syndrome.At the same time in the identification of a seizure disorder caused by various causes and brain functional or organic disease also have important clinical diagnostic value, which is the first choice for the onset of paroxysmal disease, providing strong evidence for the standardization of diagnosis and treatment.Temporal lobe epilepsy is the most common part of the origin of epilepsy, with complex partial seizure in common. Hippocampal sclerosis or degeneration,temporal lobe encephalomalacia,temporal arachnoid cyst are common imaging changes. 90.5% patients has abnormalities in long-term video EEG, providing important value for clinical diagnosis. There was no significant difference between monotherapy and combination therapy, drug therapy is still the preferred method of TLE. New antiepileptic drug such as oxcarbazepine, levetiracetam, valproate is effective, can be used as the preferred treatment of TLE.