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单纯疱疹病毒性脑炎的临床和脑电图评估 |
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姜凤英 薛一帆 丁铭臣
【摘要】目的 探讨单纯疱疹病毒性脑炎(HSE)患者神经系统主要临床症状与脑电图(EEG)异常程度、异常范围的相关性。方法 回顾性统计、对比、分析31例HSE患者住院早期、用无环鸟苷(ACV)治疗4～8天和出院前三个病程阶段的神经系统主要临床症状和疗效状况，及与其相对应的EEG异常程度和异常范围的变化。结果 HSE患者神经系统主要临床症状为精神症状、癫痫、意识障碍、记忆力下降；在前两个病程阶段，四种症状的EEG异常程度和异常范围的排序基本相同，并与病情呈同步变化；经ACV治疗后，EEG异常范围缩小的幅度比异常程度减轻的幅度小。结论 EEG异常范围和异常程度的变化可同步反映HSE患者神经系统主要症状的变化，当异常范围的变化幅度与异常程度变化幅度有一定差距时，可能说明患者正由急性期向稳定——恢复期转变。
【关键词】单纯疱疹病毒性脑炎 脑电图
Herpes simplex encephalitis:a clinical and electroencephalograph assessment
Jiang Fengying,Xue Yifan,Ding Mingchen
(Department of Neurology,Xuanwu Hospital,Capital University of Medical Sciences，Beijing 100053)
【Abstract】Objective To evaluate the relationship between clinical manifestations and electroencephalograph (EEG) in herpes simplex encephalitis(HSE).Methods Thirty-one patients with HSE were assessed in the retrospective study.The course of disease were divided into three phases,which were the first phase,early stage in hospital;second phase,4～8 days after acyclovir (ACV) treatment;and the third phase,before leaving hospital.Clinical manifestations and EEG were analyzed in 3 different phases respectively.Results Patients had one or more of the following neurological signs:behavioral changes,epilepsy,consciousness,and memory disturbances.In the first and second phase,the changes of clinical manifestations and EEG were corresponding.Conclusions The changes of clinical manifestations are corresponding to the changes of EEG.In abnormal EEG,if there is some difference between the changes of level and field,that may mean a shift from acute period to stable convalescence.
【Key words】Herpes simplex encephalitis Electroencephalography
单纯疱疹病毒性脑炎(HSE)患者，起病急、病情凶险，未经有效抗病毒治疗者，神经系统后遗症多，病死率＞70%。若能尽早应用无环鸟苷(ACV)治疗，则其病死率可降至19%［1］。业已证实，脑电图(EEG)的异常程度与脑炎患者的病情凶险程度具有平行关系，异常率高［2，3］。但对于具有不同临床表现特征的各种HSE患者与其EEG者异常情况之间关系如何?值得进一步研究。现将我院近期内31例HSE者临床和EEG评估的回顾性研究报道如下。
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