摘要目的 探讨长程视频脑电图(VEEG)监测在新生儿惊厥中的应用价值.方法 收集2011年6月至2012年6月入住武汉市儿童医院新生儿科有惊厥发作风险并进行床边长程VEEG监测的36例新生儿的临床资料并随访.临床资料包括年龄、性别、诊断、长程VEEG背景活动、(癎)性放电、癫(癎)性发作(电发作、电临床发作或二者并存)、非癫(癎)性发作.结果 36例新生儿长程VEEG中,正常、轻、中、重度异常分别为3例(8.3％)、9例(25.0％)、16例(44.4％)和8例(22.2％).VEEG正常的患儿生长发育均正常,VEEG轻、中、重度异常的患儿中发育落后的患儿比例分别为11.1％、37.5％和62.5％,存在明显相关性(x2=13.8,P=0.003).36例患儿中,21例(58.3％)有发作,其中14例(66.7％)为癫(癎)性发作,6例(28.6％)为非癫(癎)性发作,1例(4.8％)为癫(癎)性发作与非癫(癎)性发作共存.随访发现21例有发作的患儿中,13例(61.9％)神经发育不良(包括发育落后和死亡),有否发作与不良预后间无关联(x2=0.206,P=0.65).结论 新生儿惊厥在新生儿中非常普遍,但有许多不伴有临床相关表现.利用长程VEEG监测能更好地提高新生儿惊厥的诊治能力.

abstractsObjective To evaluate the efficiency of long-term video electro-encephalography(VEEG) monitoring in neonatal seizure.Methods The medical records of 36 neonates recruited and performed with long-term VEEG in the neonatal intensive care units in hospital from Jun.2011 to Jun.2012 were collected.The medical records included age,gender,diagnosis,VEEG background,epileptiform activity,epileptic seizures (electrographic seizures,electroclinical seizures or both),and nonepilepic events.Informations on prognosis and therapy was also obtained.Results Among the 36 neonates,the neonates with normal,or mildly,moderately,and severely abnormal VEEG were 3 (8.3％),9 (25.0％),16 (44.4％) and 8 (22.2％) neonates,respectively.Children with normal electro-encephalography (EEG) developed normally.The percentage with developmental delay in children with mildly,moderately,and severely abnormal EEG were 1 1.1％,37.5％ and 62.5％,respectively and abnormal VEEG was significantly associated with developmental delay(x2 =13.8,P =0.003).Among these 36 neonates,21 cases had neonatal seizures (58.3％),including 14 (66.7％) cases with epileptic seizures and 6(28.6％) cases with nonepileptic seizures and 1 case with both.In addition,13 (61.9％) cases out of 21 cases with neonatal seizures developed abnormally (including developmental delay and death),and there was no significant association between neonatal seizure and development (x2 =0.206,P =0.65).Conclusions Neonatal seizure is very common,but electroclinical dissociation is an outstanding feature of neonatal seizures.Long-term VEEG monitoring is a valuable tool and may aid in the early identification and management of patients who are more likely to develop epilepsy.