ObjectiveVideo electroencephalography (VEEG) monitoring for health education of elderly patients based on a process-based communication model, and explore the impact of this model on the success rate, negative emotions, nursing satisfaction, and active cooperation rate of such patients.MethodsFrom September 2017 to September 2019, 118 patients with suspected epilepsy, encephalitis and other diseases who required VEEG monitoring in Suining Central Hospital were selected for this study (patients aged 61 to 73 years; 54 males and 64 females). Patients were divided into 2 groups using a random number table method, 59 patients in each group.A group received routine nursing, and B group received health education based on the process communication model. The monitoring success rate, negative emotion, active cooperation rate, and nursing satisfaction were compared between the two groups.ResultsThe total effective rate in the B group was 86.44%, which was significantly higher than 76.27% in the A group (P<0.05). After nursing intervention, the scores of anxiety and depression in the two groups were significantly decreased, but the decline was greater in the B group (P<0.05). The active cooperation rate and nursing satisfaction of the B group were significantly higher than those of the A group (P<0.05).ConclusionCompared with conventional nursing, health education based on process communication mode can significantly improve the success rate of VEEG monitoring in elderly patients, alleviate the negative emotions of patients, improve the active cooperation rate and nursing satisfaction.
【摘要】 目的 探讨用视频脑电图和MRI诊断药物难治性癫痫的临床价值。 方法 收集2006年12月-2010年5月间经手术和病理证实的药物难治性癫痫患者38例。其中，海马硬化25例，颞叶萎缩伴脑发育不良2例，脑灰质移位及巨脑回4例，血管畸形3例，胶质瘤2例，脑内囊肿1例，外伤性癫痫1例。用视频脑电图监测癫痫发作期及发作间期痫样放电的来源部位及脑电活动特点，用MRI扫描显示痫灶区的表现特征，并与手术、病理改变对照，进行回顾性分析。 结果 视频脑电图对癫痫发作期的致痫灶来源定位准确率为100%（38/38），发作间期定位准确率为53%（20/38）。MRI对发作间期的致痫灶及相关病变定位诊断准确率为89%（34/38），病变定性准确率为79%（30/38）。 结论 视频脑电图和MRI检查有机结合，对药物难治性癫痫，能更有效检出致痫灶的部位及性质，为药物难治性癫痫患者的手术治疗，提供重要信息。【Abstract】 Objective To study the clinical diagnosis value of video-electroencephalography (EEG) and MRI on pharmacal intractable epilepsy. Methods From December 2006 to May 2010, 38 cases of pharmacal intractable epilepsy were confirmed through operation and pathologic examination. Among them, there were 25 cases of hippocampal sclerosis, 2 cases of temporal lobe atrophy combined with brain dysplasia, 4 cases of heterotopic gray matter and macrogyria, 3 cases of vascular malformation, 2 cases of glioma, 1 case of cyst in brain, and 1 case of traumatic epilepsy. Video-EEG was applied to monitor the source of epileptoid discharge and the features of brain electrical activity during and between the occurrences of epilepsy. MRI was used to detect the manifestation characteristics of the epilepsy focus, and retrospective analysis was done to compare these findings with operational and pathological results. Results The accuracy rate of Video-EEG in locating the epilepsy focus was 100% (38/38) during the occurrence of epilepsy, and 53% (20/38) between the occurrences of epilepsy. The accuracy rate of MRI in diagnosing the epilepsy focus and relevant abnormalities during the occurrence of epilepsy was 89% (34/38), and 79% (30/38) in characterizing the abnormalities. Conclusion Video-EEG combined with MRI examination is effective in locating and characterizing the epilepsy focus, which can provide more useful information for the surgery in treating pharmacal intractable epilepsy.
ObjectiveThe aim was to summarize the seizure and video electroencephalogram (VEEG) characteristics of Dyke-Davidoff-Masson syndrome (DDMS). Methods The case data of four patients with Dyke-Davidoff-Masson syndrome (DDMS) who attended the Epilepsy Center of Hunan Provincial Brain Hospital from March 2022 to March 2023 were retrospectively analyzed to summarize the clinical manifestations of their seizures and the characteristics of their video electroencephalogram (VEEG). Results One case of symptomatic epilepsy with focal seizures; VEEG showed poor background activity alpha rhythmic modulation, amplitude modulation, and increased distribution of slow wave activity in the left frontal and temporal regions; bilateral frontal-central and anterior-temporal regions (more so on the left side), with sharp and slow composite wave issuance.Two cases of symptomatic epilepsy with focal seizures progressing to generalized seizures; in one case, the VEEG showed: background activity α-rhythmic modulation, amplitude modulation is possible, the left frontal, central, anterior temporal region slow wave increase; the left frontal central, parietal anterior temporal region spike-like slow wave activity mixed with spike wave, spike-slow complex wave short-medium-range issuance; the other VEEG showed: background activity α-rhythmic modulation, amplitude modulation is possible, the right frontal central, anterior temporal region slow wave increase; right frontal, central, and anterior temporal region for the famous medium-extremely high-high-amplitude slow wave activity mixed with spike wave, spike-slow complex wave short-medium-range issuance. One case of symptomatic epilepsy with generalized seizures; VEEG showed bilateral occipital alpha rhythm asymmetry, right occipital region <50% of the left side, poor regulation and amplitude modulation; bilateral frontal pole, frontal region, anterior temporal region spike and spiking slow complex wave discharges (right side was prominent), and right pterionic electrodes, anterior temporal and mesial temporal spike and spiking slow wave discharges. Conclusions Epileptic seizures are one of the main clinical manifestations of DDMS and most of them are consulted after a seizure, and their seizure types tend to be focal seizures or progress to generalized seizures, and most of them are drug-refractory epilepsies. The results of VEEG monitoring tend to be characterized by abnormal background activity, increased slow-wave activity, and the site of epileptogenic wave-like discharges tends to be in line with the site of cerebral softening foci or the site of the atrophic side of the brain as shown by cranial MRI.
Objective To investigate the comfort status of patients undergoing video electroencephalogram (VEEG) examination and explore its influencing factors. Method A total of 177 patients who underwent VEEG examination in the Second Affiliated Hospital of Guangzhou Medical University from March 2023 to February 2024 were selected as the research subjects, and their comfort status and influencing factors during the examination period were analyzed. Result The comfort level of patients undergoing VEEG examination was at a moderate to high level (68.9% and 31.1%, respectively); complete mastery of VEEG health knowledge accounted for 49.2% and 65.5% in the moderate and high comfort groups, respectively. Logistic regression analysis results showed that head discomfort and lack of knowledge of VEEG health were independent influencing factors on the comfort of VEEG examination (P<0.05). Conclusions The comfort level of patients undergoing VEEG examination is at a moderate to high level of comfort; the overall mastery of knowledge related to video electroencephalography is insufficient and still needs further improvement; medical staff should pay attention to the comfort of patients and their mastery of relevant knowledge in examinations. They should take targeted intervention measures in a timely manner based on influencing factors, improve their knowledge level and cooperation with VEEG examinations, reduce the occurrence of discomfort during examinations, and improve the overall comfort level of VEEG examinations.
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.
【摘要】 目的 探讨顽固性癫痫外科术前与术中癫痫病灶定位的异同及手术方式的选择。 方法 2002年7月-2009年10月收治复杂、部分发作的顽固性癫痫78例。术前癫痫病灶定位主要采用头MRI及24 h视频脑电图检查，癫痫病灶局限于颞叶31例，颞叶、额叶47例。术中行24导皮层脑电图监测进一步定位癫痫病灶，并在其指导下联合多种癫痫术式完成手术。 结果 术前视频脑电图检查定位癫痫病灶与术中皮层脑电图监测定位具有高度一致性，但后者定位范围较前者有扩大。 结论 术中皮层脑电图监测证实并进一步精确定位癫痫病灶范围，以及在指导手术切除癫痫病灶范围，癫痫术式选择方面具有重要意义。【Abstract】 Objective To evaluate the preoperative and intraoperative epileptogenic focus location variation, and indication of surgical options for elevating outcome of refractory epilepsy patitents. Methods All of 78 refractory epilepsy patitents were complex partial seizure. Magnetic resonance imaging and 24 hour video electroencephalogram (VEEG) were used to orientate epileptogenic focus preoperatively. Thirty-one patiens were limited to temporal and forty-seven patients were both temporal and frontal. Twenty-four lead electrocorticogram (ECoG) was used to orientate epileptogenic focus intraoperatively and directed multiple operative patterns. Results Thereisa certain coherence between Preoperative VEEG and intraoperative ECoG epileptogenic focus location, but larger rangein latter. Conclusion Intraoperative e ECoG may orientate epileptogenic focus further accurately, for the suitable surgical options and appropriate surgical excision.
ObjectiveTo explore the clinical value of video-electroencephalograph (VEEG) for non-epileptic seizures disease in children. MethodsThe clinical data of 58 children with non-epileptic seizures (NES) diagnosed by VEEG from October 2010 to November 2012 were retrospectively analyzed. ResultsIn 50 out of 58 patients in the process of monitoring,the NES clinical onset was found while no synchronized epileptiform discharges was observed;in five patients with NES combined with epilepsy,no epileptiform discharges was found by VEEG at the clinical onset of NES;there were 3 patients with epileptiform discharges without seizures,who had no history of epilepsy,but non-synchronized clinical nonparoxysmal epileptiform discharges was found by VEEG monitoring. ConclusionVEEG is an effective diagnosis method for NES and seizures in children,which could be regarded as the gold standard for NES diagnosis.
ObjectiveTo investigate the video-electroencephalography (VEEG) characteristics of old patients with epilepsy (OPWE). MethodsBetween June 2013 and July 2014, 57 OPWE at an age over 60 years were assigned to research group and 65 adults between 16 and 60 years old with epilepsy were regarded as controls. All the subjects underwent VEEG for 24 hours covering awake state and sleep with hyperventilation test being applied. Chi square was used to compare occurrence rate of epileptic wave and abnormal response rate after hyperventilation between the two groups of patients. Additionally, ictal elcetroencephalograph (EEG) was analyzed. ResultsCommon features of waves on EEG for patients in both the two groups during the ictal period included widespread low amplitude fast wave (2 cases in the research group, 7.4%; 4 cases in the control group, 12.5%), focal low amplitude fast wave (5 cases in the research group, 18.5%; 6 cases in the control group, 18.8%), widespread spike or spike slowing complex (3 cases in the research group, 11.1%; 7 case in the control group, 21.8%), focal spike or spike slowing complex (5 cases in the research group, 14.9%; 8 cases in the control group, 25.0%), and focal rhythmic slow wave (6 cases in the research group, 18.5%; 6 cases in the control group, 18.8%). In the research group, there were two following cases:single abnormal background activity in 5 cases (18.5%), and neither abnormal background activity nor epileptic discharge in 1 case (3.7%). Ictal focal epileptic discharges were found in 16 cases in the research group and 8 in the control group (59.3% vs 25.0%), with statistical difference (P<0.05). Inter-ictal epilepsy discharges were found in 57 patients of the research group (awake, 15.8%; sleep, 52.6%), which was less than that in the control group (awake, 46.2%; sleep, 83.1%) with statistical difference (P<0.05), accompanied by focal slow wave (temporal intermittent rhythmic delta activity, TIRDA) in 9 cases. In natural sleep period, epilepsy discharge occurrences increased (65.3%). Abnormal response rate in the research group (14.0%) was lower than that in the control group (64.6%) with statistical difference (P<0.05). ConclusionEarly onset EEG of the old and the adult are similar except those with single abnormal background activity and those with neither abnormal background activity nor epileptic discharge. Focal onset on EEG is more frequently seen in OPWE than in APWE. In natural sleep, epileptic discharge increases among OPWE, and abnormal response during hyperventilation is less likely to happen in OPWE.
Objective To analyze the EEG characteristics and clinical significance of subclinical epilepsy from frontotemporal lobe.Methods A collection of patients with epilepsy who had subclinical seizures monitored by 24-hour video EEG from January 2020 to January 2021 in the Neurology Department of General Hospital of Tianjin Medical University General Hospital, and analyzed the duration of seizures and the number of seizures on the EEG.The characteristics and clinical significance of onset time (sleep period/waking period), interictal discharge, and number of leads involved in seizures.Results A total of 18 patients were enrolled, and 280 clinical seizures (11/18) and 34 clinical seizures (9/18) were captured. Among them, 2 patients had both subclinical seizures and clinical seizures. Frontal lobe origin, 235 subclinical seizures and 15 clinical seizures; temporal lobe origin, 26 subclinical seizures and 19 clinical seizures; frontotemporal lobe origin, subclinical seizures 19 times, no clinical seizures were captured. In the subclinical seizure group (11/18), there were 163 sleep episodes (58.2%) and 117 (41.8%) during waking phase; in the clinical seizure group (9/18), 16 episodes during sleep (47.1%) , 18 seizures (52.9%) in the awake period. Among the leads involved in seizures, <6 leads, 270 subclinical seizures, and no clinical seizures; ≥6 leads, subclinical seizures 10 times, and 34 clinical seizures. In the total duration of seizures: the clinical seizure group was (27.43±17.73) s, with a median value of 30s; the subclinical seizure group was (20.10±15.68) s, with a median value of 13 s. In the analysis of Spearman related factors, the subclinical seizure group was positively correlated with the sleep period (P=0.000), and negatively correlated with the normal nuclear magnetic field (P=0.004).Conclusion The epilepsy originated from the frontotemporal lobe has the characteristics of short clinical seizures, fewer leads involved, more likely to occur during sleep, and subclinical seizures that are more likely to occur when the MRI is abnormal. Therefore, strengthening the monitoring of long-term video EEG for patients with epilepsy and attaching importance to the interpretation of EEG during sleep will help to detect the subclinical seizures of patients and further improve the management of patients with epilepsy.