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一名2岁持续性意识障碍儿童的脑电图评估:3年随访

EEG Assessment in a 2-Year-Old Child with Prolonged Disorders of Consciousness: 3 Years' Follow-up.

作者信息

Xu Gang, Sheng Qianqian, Xin Qinggang, Song Yanxin, Zhang Gaoyan, Yuan Lin, Zhao Peng, Liang Jun

机构信息

Rehabilitation Branch, Tianjin Children' Hospital, Tianjin 300400, China.

Tianjin Tianshi University Medical College, Tianjin 301700, China.

出版信息

Comput Intell Neurosci. 2020 Nov 21;2020:8826238. doi: 10.1155/2020/8826238. eCollection 2020.

Abstract

A 2-year-old girl, diagnosed with traumatic brain injury and epilepsy following car trauma, was followed up for 3 years (a total of 15 recordings taken at 0, 2, 3, 4, 5, 6, 7, 9, 10, 11, 12, 14, 19, 26, and 35 months). There is still no clear guidance on the diagnosis, treatment, and prognosis of children with disorders of consciousness. At each appointment, recordings included the child's height, weight, pediatric Glasgow Coma Scale (pGCS), Coma Recovery Scale-Revised (CRS-R), Gesell Developmental Schedule, computed tomography or magnetic resonance imaging, electroencephalogram, frequency of seizures, oral antiepileptic drugs, stimulation with subject's own name (SON), and median nerve electrical stimulation (MNS). Growth and development were deemed appropriate for the age of the child. The pGCS and Gesell Developmental Schedule provided a comprehensive assessment of consciousness and mental development; the weighted Phase Lag Index (wPLI ) in the -band (13-25 Hz) can distinguish unresponsive wakefulness syndrome from minimally conscious state and confirm that the SON and MNS were effective. The continuous increase of delta-band power indicates a poor prognosis. Interictal epileptiform discharges (IEDs) have a cumulative effect and seizures seriously affect the prognosis.

摘要

一名2岁女童在车祸后被诊断为创伤性脑损伤和癫痫,进行了3年的随访(在0、2、3、4、5、6、7、9、10、11、12、14、19、26和35个月共进行了15次记录)。对于意识障碍儿童的诊断、治疗和预后,目前仍没有明确的指导意见。每次就诊时的记录包括患儿的身高、体重、小儿格拉斯哥昏迷量表(pGCS)、修订版昏迷恢复量表(CRS-R)、格塞尔发育量表、计算机断层扫描或磁共振成像、脑电图、癫痫发作频率、口服抗癫痫药物、叫患儿名字刺激(SON)和正中神经电刺激(MNS)。生长发育被认为与患儿年龄相符。pGCS和格塞尔发育量表对意识和智力发育进行了全面评估;13 - 25Hz频段的加权相位滞后指数(wPLI)可区分无反应觉醒综合征和最低意识状态,并证实SON和MNS有效。δ频段功率持续增加表明预后不良。发作间期癫痫样放电(IEDs)具有累积效应,癫痫发作严重影响预后。

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