·4O·中华妇幼临床医学杂志(电子版)2008年1O月第4卷第5期ChinJObs／Gyne＆Pediatr(Elec仃onicVersion)，October2008，Vo1．4，No．5儿童14Hzl~6Hz正相棘波79例临床分析罗双红罗蓉陈凤谢莉萍【摘要】目的探讨14Hz&6Hz正相棘波的脑电波特点与临床意义。方法对2005年8月至2007年6月在四川大学华西第二医院小儿神经科接受4h清醒一睡眠一清醒视频脑电图(video—electroencephalogram，video—EEG)连续监测的1321例患儿中，79例出现14Hz&6Hz正相棘波的患儿临床资料和脑电图进行回顾性分析。结果本组患儿资料显示，14Hz6Hz正相棘波在脑电图特征、年龄、性别分布：均在非快速眼动期睡眠(non—rapideyemovementsleep，NREM)出现，集中于中、后颞区，一侧或双侧发放，常波及中央、顶、枕区，呈连续发放(1岁以下未见)。男、女患儿14Hz&6Hz正相棘波出现几率比较，差异无显著意义；癫痫患儿与非癫痫患儿的出现几率比较，差异无显著意义。本组79例出现14Hz＆6Hz正相棘波的患儿，均有突出的精神运动发育迟滞、小儿急性偏瘫、过敏性紫癜、脑挫伤、颅内感染等器质性病变，癫痫发作和反复多次发作或有阳性家族史的热性惊厥，头痛、腹痛、晕厥、呕吐等自主神经症状，存在注意力缺陷、心理问题、抽动等精神行为障碍及睡眠障碍，1例死亡。本组79例患儿中，63例睡眠期脑电监测出现14Hz&6Hz正相棘波的多次频繁发放。结论对于14Hz&6Hz正相棘波的临床诊断价值问题迄今尚存争议，还有待大量不同年龄段正常儿童连续睡眠脑电图资料的积累。因此，不能将14Hz&6Hz正相棘波用于诊断癫痫或其他发作性疾病，但也不能简单地将其认作发育期的正常脑波表现，一旦临床监测到，应积极作其他相关检查，寻找病因，以免漏诊。【关键词1t4Hz&6Hz正相棘波；儿童；癫痫ARetrospectiveStudyof79ChildrenWith14Hz＆6HzPositiveSpikes．LUOShuang—hong，LUORong，CHENFeng，XIELiping．DepartmentofPediatrics，thegsChinaSecondUniversityHospital，SichuanUniversity，Chengdu610041，China．[Abstract]ObjectiveToinvestigatethesignificantfeaturesandclinicalsignificanceofthe14Hz＆6Hzpositivespikeselectroencephalogram(EEG)．MethodsAretrospectivestudyon79childrenwith14Hz&6Hzpositivespikepatterninl321videoEEGfromtheDepartmentofPediatrics，WestChinaSecondUniversityHospital，SichuanUniversityfromAugust2005toJune2007。andtheirclinicalfeaturesandelectrogramwereanalyzed．Al1the1321video—EEGrecordswereobtainedwiththe“10-20”internationa1systemofelectrodeplacementand16-channelEEGmachine，andtheirwakefulness，drowsystate，sleepandwakingupstateweremonitoredandrecordedcontinually．ResultsAtotalof79childrenhavebeenfoundwiththe14Hz＆6Hzpositivespikepatternin1321patients．ThestatisticsindicatedthattherewasnosignificantdifferenceinEEGsfeatures，genderandagedistributionsofthe14Hz＆6Hzpositivespikes，accordingtothepreviousreports：the14Hz&6Hzpositivespikesoccuredalmostduringdrowsinessandlightsleep，appearedinmid—posteriortemporalconeentratly，dischargedcontinuallyinunilateralorbilateralencephalicregionanddidnotfoundininfantsunder1-year—old：therewasnosignificantdifferencebetweenboysandgirlsinincidencerateandnosignificantdifferencebetweenepilePsygroupandnon—epilepsygroupinincidencerate．Butdifferently，al1childrenhadnoticeablesymptoms。includingorganicdisease(suchasmentalretardation，acutehemiplegia，anaphylactoidpurpura，braincontusionorintracranialinfections)，seizuresorcomplicatedfebrileconvulsions，autonomicnervoussymptoms(forexampleheadache，abdominalpain，faintingandvomiting)，mentalorbehaviordisorders(suchasAttentiondeficithyperactivitydisorder，psychologicalproblemsandticdisorder)anddyssomnia．Mostofthemhadthe14Hz&6Hzpositivespikesdischargedmanytimesorfrequently．Onlyonechil...
