Onoe Sachiko, Nishigaki Toshinori
Department of Pediatrics, Osaka Police Hospital, 10-31 Kitayama-cho, Tennouji-ku, Osaka 543-0035, Japan.
Brain Dev. 2004 Dec;26(8):513-8. doi: 10.1016/j.braindev.2004.02.004.
Febrile delirium is defined as an acute and transient confusional state with high fever. There are very few reports on febrile delirium, although fever is one of the commonest symptoms in children. We previously found a posterior slowing in the electroencephalogram (EEG) of delirious patients with fever. The purpose of this study is to evaluate the features of occipital slow waves by spectral analysis and to find a parameter associated with clinical improvement.
Digital EEG tracings were investigated by Fourier analysis in 20 patients aged from 2 to 13 years. The fast Fourier transform (FFT) was computed for 20 s tracing from the P3-A1 and P4-A2 derivations. The spectral analysis of EEG was repeated in 7 patients. The tracings of 34 control subjects were also analyzed by FFT. EEG of a febrile, nine-year-old girl without delirium was also studied.
Febrile delirium was seen during the first three days of fever. The episodes lasted up to 10 min. Four patients showed febrile delirium again after admission but they became conscious a few minutes later. The relative power in the delta frequency band was increased in 65% of patients with preservation of the occipital alpha rhythm. In addition, repeated febrile delirium did not cause worsening of the posterior slowing. The duration of abnormal EEG was only a few days and the decrease of relative power in the delta frequency band was the best parameter of clinical improvement. Posterior slowing was also found in a febrile patient without delirium.
Febrile delirious children showed the characteristic clinical and spectral analytical features and the numerical data of EEG facilitate the comparison of the serial findings.
发热性谵妄被定义为伴有高热的急性和短暂性意识模糊状态。尽管发热是儿童最常见的症状之一，但关于发热性谵妄的报道却非常少。我们之前发现发热的谵妄患者脑电图（EEG）存在枕叶慢波。本研究的目的是通过频谱分析评估枕叶慢波的特征，并找到与临床改善相关的参数。
对20名年龄在2至13岁的患者进行数字脑电图描记，并通过傅里叶分析进行研究。从P3 - A1和P4 - A2导联进行20秒的描记，计算快速傅里叶变换（FFT）。对7名患者重复进行脑电图的频谱分析。还对34名对照受试者的描记进行了FFT分析。对一名无谵妄的发热9岁女孩的脑电图也进行了研究。
发热性谵妄出现在发热的前三天。发作持续长达10分钟。4名患者入院后再次出现发热性谵妄，但几分钟后恢复清醒。65%枕叶α节律保留的患者在δ频段的相对功率增加。此外，反复的发热性谵妄并未导致枕叶慢波加重。异常脑电图的持续时间仅为几天，δ频段相对功率的降低是临床改善的最佳参数。在一名无谵妄的发热患者中也发现了枕叶慢波。
发热性谵妄儿童表现出特征性的临床和频谱分析特征，脑电图的数值数据有助于对系列研究结果进行比较。
