Hughes J R
University of Illinois Medical Center, Chicago 60612, USA.
Clin Electroencephalogr. 1996 Jan;27(1):35-9. doi: 10.1177/155005949602700106.
The goal of this paper is to draw conclusions about the usefulness of the standard EEG in psychiatry. In general, two thirds of psychiatric referrals for an EEG are expected to provide useful information. The emphasis in schizophrenia is placed on left-sided abnormalities, especially on the left temporal area. In mood disorders the emphasis is on right-sided foci, in addition to the controversial 6/sec spike and wave complexes, small sharp spikes and positive spikes. In the acute stage of alcoholism, a relationship is seen between the degree of intoxication and the amount of slow activity, while in the chronic stage an increase in slow activity is seen, but another change is fast activity on the temporal areas. During withdrawal a low seizure threshold can be seen as irregular bilateral spike and wave complexes. During abstinence 2-4 yr may be required before slow wave sleep is normal in all regards. Among the organic mental syndromes, delirium shows slow activity, except in delirium tremens, which often is associated with a normal record with fast activity. In dementia the prevalence of EEG abnormalities is related to the degree of impairment. After five sessions of ECT diffuse slow waves are often seen. In other conditions, among developmental disorders about one half of autistic children show abnormalities and epileptiform activity is not uncommon. Mild nonspecific abnormalities are seen in about 40% of dyslexics and also in behavior disorders. Anxiety disorders include anorexia nervosa, showing abnormal background activity related to the effect of starvation on cerebral metabolism. In panic attacks paroxysmal activity can be seen. In borderline personality positive spikes have been (again) associated with impulsivity and 6/sec spike and wave complexes with interpersonal problems. Of the drugs of abuse psilocybin and phencyclidine are often associated with generalized epileptiform patterns and with marijuana the alpha shows a decreased frequency with increased amplitude. Typically, an increase in slow activity is seen with psychotropic drugs if there is a change in the level of awareness. Finally, distinctive personality traits are, at times, seen in temporal lobe epilepsy and the phenomenon of "forced normalization" may appear when seizures stop and psychotic symptoms appear.
本文的目的是得出关于标准脑电图在精神病学中效用的结论。一般来说，三分之二因精神病学原因转诊进行脑电图检查的病例有望提供有用信息。精神分裂症的重点在于左侧异常，尤其是左侧颞叶区域。在情绪障碍中，重点在于右侧病灶，此外还有存在争议的6次/秒棘波和慢波复合波、小棘波和正棘波。在酒精中毒急性期，可观察到中毒程度与慢波活动量之间的关系，而在慢性期则可见慢波活动增加，但另一个变化是颞叶区域的快波活动。戒断期间，低惊厥阈值可表现为不规则双侧棘波和慢波复合波。在禁欲2至4年后，慢波睡眠在各方面才可能恢复正常。在器质性精神综合征中，谵妄表现为慢波活动，但震颤谵妄除外，后者通常脑电图记录正常且伴有快波活动。在痴呆症中，脑电图异常的发生率与损害程度相关。在进行5次电休克治疗后，常可见弥漫性慢波。在其他情况中，在发育障碍中，约一半自闭症儿童存在异常，癫痫样活动并不罕见。约40%的诵读困难者以及行为障碍者可见轻度非特异性异常。焦虑症包括神经性厌食症，其显示出与饥饿对大脑代谢的影响相关的异常背景活动。在惊恐发作时可见阵发性活动。在边缘型人格障碍中，正棘波（再次）与冲动性相关，6次/秒棘波和慢波复合波与人际问题相关。在滥用药物中，裸盖菇素和苯环己哌啶常与全身性癫痫样模式相关，而大麻则表现为α波频率降低、波幅增加。通常，如果意识水平发生变化，使用精神药物时可见慢波活动增加。最后，独特的人格特质有时可见于颞叶癫痫，当癫痫发作停止且出现精神症状时可能会出现“强制正常化”现象。
