It is an important means to study the electrical activity of the brain's nerve cells by exploring physiological information of the EEGs from the frequency domain. The gravity frequency is one of the global parameters with using this method. We used the multitaper spectrum method (MTM) spectrum estimation method of good performance to calculate the EEG spectrum and its gravity frequency of subjects under vigilance and vigilance decrement state. The results showed that the gravity frequency of vigilance state was higher than that of vigilance decrement state, the gravity frequency became smaller along with the vigilance decrement, and the location of the gravity frequency shifted to the left in the spectrum. Finally, the monitoring curve of the gravity frequency was acquired by designing an algorithm, and it was used to online monitoring vigilance operators.
Objective To investigate the clinical and EEG characteristics, therapeutic response and prognosis in children with atypical absence seizures. Methods The clinical and EEG data of 43 children with atypical absence seizures in Qilu Hospital, Shandong University during January 2011 to December 2016 were analyzed, and therapeutic response and prognosis were followed up. Results Childre were 24 male and 19 female with the mean age of 5.43 y. The onset ages were from 1 years and 8 months to 10 years and 3 months. All of the 43 patients had MRI examines, and 18 children were normol. MRI abnormalities appeared in 25 children, including cerebral cortical dysplasia and cerebral atrophy (13 cases), congenital corpus callosum hypoplasia (2 cases), and abnormal signal in bilateral posterior putamen (2 cases), encephalomalacia focus(4 cases), ventricle expention (2 cases), hydrocephalus(2 cases). All the children underwent EEG more than once. All children had atypical absence seizures during daytime. Children had slowly backgrounds in retesting EEG, and spine and slow waves of 1.5 Hz to 2.8 Hz could be seen in all the atypical absence seizures. All children were followed up, and except 6 children with complete control, 19 children’ parents reported seizure- free, 18 children have poor effect. Forty Children had various degrees of psychological abnormalities and motor regression. Among them 13 cases had psychological abnormalities and motor regression before disease; cognitive ability of 27 cases were normal before onset age, however, about 75% to 95% of the children became abnormal 2 years after atypical absence seizures. The rest 3 cases had no obviously impairment. Conclusions Most of the atypical absence seizures children had small onset age and high incidence in mental damage and cognitive impairment. The course of typical absence seizures aggravate gradually, and often develops to nonspecific brain damage in this process. Antiepileptic drugs can reduce the frequency of the seizure in part of the patients, but had no effect on psychological and motor regression.
ObjectiveThe purpose of this study was to compare the value of SEEG and subdural cortical electrodes monitoring in preoperative evaluation of epileptogenic zone. MethodsFeatures of patients using SEEG (48 cases) and subdural cortical electrodes monitoring (52 cases) to evaluate the epileptogenic zone were collected from June 2011 to June 2015. And the evaluation results, surgical effects and complications were compared. ResultsThere was no significant difference between SEEG and subdural cortical electrodes monitoring in identifying the epileptogenic zone or taking epileptic surgery, but SEEG could monitor multifocal and bilateral epileptogenic zone. And there was no significant difference in postoperative seizure control and intelligence improvement (P > 0.05). The total complication rate of SEEG was lower than subdural cortical electrodes monitoring, especially in hemorrhage and infection (P < 0.05). ConclusionsThere was no difference among SEEG and subdural cortical electrodes monitoring in surgical results, but SEEG with less hemorrhagic and infectious risks. SEEG is a safe and effective intracranial monitoring method, which can be widely used.
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.
Objective To investigate the clinicalmanifestations, electroencephalogram (EEG) characteristics, surgical treatment and prognosis of epilepsy secondary to Sturge-Weber syndrome (SWS) in children.Methods The data of 7 children with epilepsysecondaryto Sturge-Weber syndrome who were treated by surgery from May 2015 to May 2020 in our Children's Epilepsy Center were retrospectively reviewed. Their demographic characteristics, seizure forms, results of EEG and cranial imaging investigations, surgical methods, postoperative pathological reports and prognosis during follow-upwere summarized and analyzed. The prognosis were evaluated byEngel classificationat the last time point during follow-up. Results Totally 7 pediatric patients were enrolled, including 1 male (16/25, 64.0%) and 6 females.All the 7 cases presented with focal seizures at the onset among whom 2 cases developed status epilepticus during the course of the disease(epilepsiapartialiscontinuain 1 case),one case had epileptic spasmsand 1 case was characterized by cluster seizures. The interictal EEG manifestations of the cases gradually deteriorated as the course of the disease prolonged, including the slow wave on the affected side gradually increases (7/7), the amplitude gradually decreases (7/7), and the physiological wave disappears (4/7). Besides, no epileptiform discharges/incidental or a few epileptiform dischargeswere found in their interictal EEGs. Four cases underwent hemispherotomy, 1 case underwent temporo-parieto-occipital disconnection and 2 cases underwent lesion resection. The cases were followed up for 6 months to 5 years, and the average follow-up duration was 79.29 months. Six cases were rated as Engel Ⅰa during the regularfollow-up. Only 1 case was rated asEngel Ⅱ and Engel Ⅲ at 3 month and 1 year after the operation. ConclusionChildren with epilepsy secondary to SWS usually present with focal seizures and have diverse seizure forms. The EEG show characteristic changes. For the caseswith drug refractory epilepsy, detailed preoperative evaluation and reasonable surgical methods can result in a better therapeutic effect.
ObjectiveTo discuss the scientific research and application value of the new China Association Against Epilepsy (CAAE) EEG reporting system, and to explore the model of establishing EEG database of tertiary comprehensive epilepsy center. MethodsA retrospective study was performed on outpatients who underwent EEG examination at the Epilepsy Center of Tsinghua University Yuquan Hospital from May 2021 to May 2022, and who also received EEG reports using the CAAE new EEG reporting system. We integrated the data of these 6380 patients with the previous database of our Epilepsy Center, and combined the two for the preliminary big data analysis. Results Among 6380 patients, normal EEG was reported in 2253 cases (35.3%) ,abnormal EEG in 4031 cases (63.2%), no definite abnormality in 96 cases. According to age groups, there were 3290 cases in children (51.0%), 1372 cases in adults (22.0%), 753 cases in adolescents (12.0%), 730 cases in infants (11.0%) and 235 cases in infants (4.0%).A total of 1466 (23.0%) patients were recorded with paroxysmal events, including 874 (60.0%) epileptic events. 517 (35.0%) non-epileptic events. ConclusionThe new EEG reporting system can provide a large number of researchable EEG data to guide clinical work, and it is an important tool for data sharing and big data research in the future.
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.
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.
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.