간질 환자에 관한 임상뇌파학적 고찰

CLINICAL ELECTROENCEPHALOGRAPHICAL SURVEY TO THE EPILEPTICS

In this survey, it was intended to reveal the characteristic EEG findings of the epileptics as to their proportion of the abnormal EEG and it’s analysis of their significant wave pattern, location, localization, symmetry, synchrony, and runs in waking record according to the clinical types of seizure. The 766 cases of the clinical epileptics who had undergone EEG examination for convulsion from Jan. 1971 to Dec. 1974 at the Chung Ang University Hospital EEG Laboratory were included in this survey. The results were as follows: 1. As to the distribution of clinical types in the 766 cases of epileptics, it was revealed that the grand mal seizure was 71.3%, focal motor seizure; 9. 7% ，petit mal seizure; 8. 1% ， myoclonic seizure; 2. 2%, infantile spasm； 2. 2%, centrencephalic and focal seizure； 1. 8%, focal sensory seizure； 1.7%, psychomotor seizure: 1.4%, thalamic seizure； 0.9%, and autonomic seizure was 0.7%. 2. In the proportion of the abnormal EEG of 766 epiletics, 53.7% of them showed abnormal EEG findings and 45.3% showed normal recordings. Of clinical types, myocloic seizure (82.4% )， centrencephalic and focal seizure (78.6%), thalamic seizure (71.4%), and petit mal seizure (71.0%) were relatively higher percentage of the abnormal EEG findings. In the sex and age distribution, the female occupied higher percentage of the abnormal EEG findings (58. 7%) comparing with the male epileptics (49- 5%) ； and the younger age group occupied higher percentage (74.3%) of the abnormal EEG findings comparing with the older age group (35.8%). And this tendency was predominantly observed among the focal motor seizure, petit mal seizure and grand mal seizure. 3. Among 322 cases of epileptics who showed the abnormal EEG findings in waking record, it was revealed that the centrencephalic seizure was higher rate (88- 0%) than focal motor seizure (8. 6%); and the younger age group, especially in petit mal seizure, was higher rate than older age group. 4. As to the proportion of diagnostically significant abnormal wave patterns, theta wave (79.6%), beta wave (19.4%), sharp wave (15. 2%) and spike (13.4%) were predominatly observed. The significant abnormal wave patterns of the EEG revealed that petit mal seizure was 3 c/s spike and wave； myoclonic seizure was theta wave, sharp wave, or temporal lobe epilepsy was irregular spike and wave； and infantile spasm was polyspike, irregular spike and wave, or polyspikc and wave. 5. In the EEG analysis of location, localization, symmetry and synchrony of abnormal wave patterns in waking record, it was revealed that they were predominantly located in all leads (42.5%), maximal in the frontal lead (22. 0% ); the localized abnormalities were higher (55. 0%) than the diffuse (41. 9%) and the focalized (3.1%). The localization of the petit mal seizure or the temporal lobe epilepsy exhibited the diffuse abnormalities； and the focal seizure exhibited more tendency to be focalizedasymmetrical- asynchronous abnormalities comparing with other types. 6. For the runs of abnormal wave patterns, they showed frequently intermittent runs (50.9%) comparing with paroxysmal bursts (28.6%), isolated runs (10.9%) or constant runs (9.6%). The petit mal seizure or temporal lobe seizure exhibited more tendency to be paroxysmal bursts; grand mal seizure exhibited intermittent runs; and focaliized seizure exhibited intermettent or constant runs comparing with other types.