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.
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.
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.
Objective To explore the change of EEG waveform recorded by clinical EEG under different filtering parameters. Methods22 abnormal EEG samples of epilepsy patients with abundant abnormal waveforms recorded in Peking University first hospital were selected as the case group (abnormal group), and 30 normal EEG samples of healthy people with matched sex and age were selected as the control group (normal group). Visual examination and power spectrum analysis were then performed to compare the difference of wave forms and spectrum power under different settings of filter parameter between the two groups. ResultsThe results of visual examination show that, lower high-frequency filtering has an effect on the fast wave composition of EEG and may distort and reduce the spike wave. Higher low-frequency filtering has an effect on the overall background and slow wave activity of EEG and may change the amplitude morphology of some slow waves. The results of power spectrum analysis show that, Compare the difference between the EEG normal group and the abnormal group, the main difference under the settings of 0.5~70Hz was on the θ and α3 frequency band, different brain regions were slightly different. In the central region, the difference in the high frequency band (α3, γ1, γ2) decreases or disappears with the decrease of the high frequency filtering. In the rest of the brain, the difference in the δ band appears gradually with the increase of the low frequency filtering. Compare the difference between frontal area and occipital area under different filter set, for the normal group, under the settings of 0.5 ~ 70 Hz, the difference between two regions is mainly on the θ, γ1 and γ2 band. When high frequency filter reduces, the difference between two regions on high frequency band (γ1, γ2) are gradually reduced or disappeared. And when low frequency filter increases, the difference on δ band appears. For the abnormal group, the difference between frontal and occipital region under the settings of 0.5 ~ 70 Hz is mainly on γ1 and γ2 bands. When the high-frequency filter decreases, the difference between two regions on high-frequency bands are gradually decreased or disappeared. All the results can be corrected by FDR. ConclusionThe results show that the filter setting has a significant influence on EEG results. In clinical application, we should strictly set 0.5 ~ 70 Hz bandpass filtering as the standard.
ObjectiveTo investigate the lateralization of ictal scalp EEG in different times in focal epilepsy.Methods356 surface ictal EEG of 41 patients were reviewed retrospectively in focal epilepsy arising from the mesial frontal, lateralfrontal, mesialtemporal, neocorticaltemporal, insular lobes and posterior cortex from July, 2010 to at, 2016. Each ictal scalp EEG was subdivided into ten epoches (E1-E10), then the lateralization of every epoch was analyzed. Ten epochs EEG were merged into three timesas E1-E3, E4-E6 and E7-E10. The ratio of lateralization, mislateralization and non-lateralization of each timeEEG were studied. Ictal onset zone (IOZ) were precise localized by intracranial EEG. The results of epileptogenic zone corresponded with surgical outcomes as seizure free or decreased.Results62% seizures were lateralized by surface ictal EEG in all epilepsies. Lateralized ictal scalp EEG were seen in nearly 80% of seizures in all times in temporal lobe epilepsy (TLE). The highest lateralization of 89% occurred inE4-E6 andfalse lateralization up to 30% in E1-E3 in mesial temporal lobe epilepsy (MTLE), whereas 95% lateralized seizures emerged in E1-E3 in neocortical temporal lobe epilepsy (NTLE). Apparent non-lateralization in all times were higher than lateralization in frontal lobe epilepsy (FLE), especially in mesial frontal lobe epilepsy (MFLE). Lateralization in E1-E3 was only 24% higher than other times. In addition, False lateralization never occurred in all times in lateral frontal lobe epilepsy (LFLE). There were maximum of 83%lateralized seizures in E1-E3 in LFLE and 93% in E1-E3 in posterior cortex epilepsy (PCE). Seizures arising from insular lobe epilepsy (ILE) tendedto predict less lateralization in all times.ConclusionsIctal scalp EEG of E1-E3 are valuable in the lateralization in all epilepsies particularly in LFLE, NTLE and PCE. Lateralized E4-E6 and E7-10 are very useful in MTLE.
Objective To explore how to differentiate the epilepsy and syncope in order to minimize the misdiagnosis. Methods Retrospectively analyzed the medical record of 6 cases which were misdiagnosed as epilepsy or syncope during April 2008 to September 2012 and reviewed the literatures about the differential diagnosis. Results Among the clinical characteristics, the ictal positional tone and loss of consciousness as well as the duration of postictal confusion are very important to the differential diagnosis. The ictal EEG shows highly rhythmic abnormal discharges when epileptic seizures occur. However, the ictal EEG would become slower and flatler during syncope. Conclusions When the automomic disorder and signs such as chest distress, arrhythmia. appear, the causes should not be limited in the cardiac diseases, the functional or structural abnormalities of the nervous system innervating the heart should also be considered; on the contrary, convulsions might not only due to the abnormal electrical activity in the brain, but syncope.
ObjectiveTo explore the application value of MRS combined with VEEG on the surgical treatment of temporal lobe epilepsy. MethodsThere were 31 males and 20 females, age between 4 and 62 years.Their illness duration ranged from 4 to 10 years.The clinical manifestations showed complex partial seizure in 10 cases, secondary generalized seizure in 12 and generalized tonic-clonic seizure in 29. Based on their results of clinical manifestations, MRS and VEEG results, all the patients underwent anterior temporal lobectomy(including the most parts of the hippocampus and amydala). ResultsThe follow-up of 1~3 years after the operation showed seizure free in 36 cases(Engle Ⅰ), and significant improvement in 11(Engle Ⅱ), no improvement in 4 cases(Engle Ⅳ). The overall effective rate was 92.16%. ConclusionsMRS combined with VEEG has significant localization value for temporal lobe epilepsy. The prognosis of postoperative result is quiet good to the patient of typical temporal lobe epilepsy after anterior temporal lobectomy.
Epilepsy has been recognized as a brain network disorder. Therefore, functional MRI (fMRI)-based connectivity is an ideal technique for exploring the complex effects of epilepsy on the brain. Functional connectivity studies have provided insights into the physiopathogenesis of the epileptic network underlying focal epilepsies, genetic generalized epilepsy, and specific epileptic syndromes. An increasing number of studies have focused on the deleterious effects of epilepsy on other brain networks to help to explain cognitive deficits and psychiatric symptoms. Anti-epileptic treatment studies have yielded information about the side effects and the restoration of functional abnormalities after using the drug. Researchers who have examined predictors of surgical outcomes have suggested that there might be identifiable pre-surgical patterns of functional connectivity that are associated with a greater likelihood of positive cognitive or seizure outcomes. However, knowledge regarding the role of fMRI connectivity remains limited in clinical settings. Further validation through invasive investigations and follow-up studies is required for its reliable application in the clinical management of individual patients. (C) 2016 Published by Elsevier Ltd on behalf of British Epilepsy Association.
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.
ObjectiveTo probe the clinical features and the characteristics of radiography and electroencephalogram (EEG) of tuberous sclerosis complex(TSC) in children with epilepsy. MethodsThe clinical data of the TSC cases with epilepsy were collected from inpatients in Jiangxi Children's Hospital from Jan. 2013 to Oct. 2015. ResultsAmong the 26 cases, 21 cases(21/26, 80.77%) involved abnormalities of the skin. Of these patients, there were 10 cases with hypomelanotic macules, 7 cases with café au lait spots and 4 cases with facial angiofibromas. There were no significant difference among the different age groups. In addition, there were 8 cases (8/26, 30.77%) with spasm seizures, of whom 3 cases had partial seizure, 10 cases (10/26, 38.46%) with complex partial seizure, 5 cases(5/26, 19.23%) with secondary generalized seizure, 2 cases(2/26, 7.69%) with tonic-clonic seizure and one case with Lennox-Gastaut syndrom(1/26, 3.85%). The average onset age of the epileptic spasms group were younger than those of the other epilepsy groups (t=2.143, P=0.042). EEG monitoring demonstrated hypsarrhythmia in 7 cases (7/26, 26.92%) in the interictal EEG, focal epileptic discharges in 11 cases (11/26, 42.31%), multifocal discharges in 5 cases, the slow background activity in 2 cases and the normal EEG in one case. Cranial imaging demonstrated subependymal nodules (SEN) in 25 cases(25/26, 96.15%) was the most common. ConclusionThe clinical manifestations and seizure types of TSC in children, especially in infants and young children, were diverse and age-dependent. It was very important to improve understanding of the clinical features and related risks of TSC at various ages, which was helpful to diagnose TSC early.