Petty G W, Labar D R, Fisch B J, Pedley T A, Mohr J P, Khandji A
Department of Neurology, College of Physicians and Surgeons of Columbia University, New York, NY, USA.
J Neurol Sci. 1995 Dec;134(1-2):47-50. doi: 10.1016/0022-510x(95)00198-5.
To determine the occurrence and clinical implications of electroencephalographic (EEG) abnormalities in patients with acute lacunar infarction, we conducted a single-blinded EEG study in 55 patients. Twenty-nine (53%) had mild EEG abnormalities, which were focal and ipsilateral to the side of infarction in 7 patients (13%). Abnormalities were more common in patients with evidence of a prior stroke (10 of 12 patients, 83%). However, 43% (16 of 37 patients) of those without historical or radiologic evidence of a prior stroke also had mild EEG abnormalities. This represents a higher incidence of routine EEG abnormalities in lacunar infarction than is generally assumed. Indeed, these findings are more consistent with recent quantitative EEG studies that consistently have shown high rates of abnormalities in lacunar infarction. We did not find major EEG abnormalities, such as continuous or nearly continuous focal delta activity, in any patient with first lacunar infarction. We conclude that within the first 48 h after a first ischemic infarction, when computed tomography often fails to show abnormalities, an EEG that shows lateralized major abnormalities is useful in excluding the diagnosis of either lacunar infarction or infarction limited to the brain stem. Mild abnormalities occur more often than previously thought in lacunar infarction and do not exclude this diagnosis.
为了确定急性腔隙性脑梗死患者脑电图（EEG）异常的发生率及其临床意义，我们对55例患者进行了单盲脑电图研究。29例（53%）有轻度EEG异常，其中7例（13%）为局灶性且与梗死侧同侧。有既往卒中证据的患者异常更为常见（12例中有10例，83%）。然而，在无既往卒中病史或影像学证据的患者中，43%（37例中有16例）也有轻度EEG异常。这表明腔隙性脑梗死患者常规EEG异常的发生率高于一般认为的情况。事实上，这些发现与近期的定量脑电图研究结果更为一致，这些研究一直显示腔隙性脑梗死患者的异常率很高。在任何首次发生腔隙性脑梗死的患者中，我们均未发现严重的EEG异常，如持续性或几乎持续性的局灶性δ活动。我们得出结论，在首次缺血性梗死发生后的48小时内，当计算机断层扫描常常未能显示异常时，显示有侧化严重异常的EEG有助于排除腔隙性脑梗死或仅限于脑干梗死的诊断。腔隙性脑梗死中轻度异常的发生率比以前认为的更高，且不能排除该诊断。
