目的 分析新生儿惊厥视频脑电图特点及其Gesell发育量表测试情况,为预测新生儿惊厥预后提供理论依据。方法 收集2015年7月-2019年8月因新生儿惊厥在榆林市第二医院住院且行视频脑电图(VEEG)检查的新生儿为研究对象,分析VEEG特征,并于出生3个月后行Gesell发育量表测试。结果 1)共收录符合条件新生儿43例,新生儿期VEEG轻度异常20例,中度异常10例,重度异常13例; 2)VEEG轻度异常以阵发性异常(50%)为主;中度异常以阵发性异常(40.0%)和成熟异常(30%)为主;重度异常以背景活动异常(61.5%)为主;3)43例患儿中失访6例,共随访37例,均经Gesell发育量表测试评估,平均发育商(DQ)＜85有15例,预后不良率达40.5%(15/37);4)VEEG轻、中、重度者预后不良率分别为11.1%、60.0%、77.8%。VEEG异常程度与Gesell发育量表测试Kappa一致性检验为0.60。VEEG中-重度异常程度预测预后的敏感度86.7%,特异度:72.7%,阳性预测值68.4%,阴性预测值88.9%。结论 VEEG和Gesell发育量表测试对新生儿惊厥预后的预测价值并不完全一致;应用VEEG异常程度预测预后有较高的敏感度和阴性预测值,但特异度和阳性预测值偏低;临床上往往需要很长的时间综合评估才能对惊厥患儿的神经发育做出更精准的判断。

Objective To investigate the correlation between video electroencephalogram (VEEG) and Gesell Developmental Scale (GDS) in neonates with convulsion, in order to provide theoretical reference for predicting the prognosis of neonates with convulsion. Methods From July 2015 to August 2019, newborns who were hospitalized with neonatal convulsion and underwent VEEG examination in Yulin Second Hospital were collected as study subjects.VEEG characteristics in the neonatal period was analyzed, GDS test was performed 3 months after birth. Results 1) A total of 43 eligible newborns were included, including 20 cases of mild VEEG abnormality, 10 cases of moderate abnormality and 13 cases of severe abnormality.2) Mild VEEG abnormalities were mainly paroxysmal abnormalities (50%), and the moderate abnormality was mainly paroxysmal abnormality (40.0%) and mature abnormality (30%).Background activity (61.5%) was the main abnormal condition.3) A total of 38 children were followed up, including 6 lost in follow-up.The results of GDS test showed that the prognosis of 15 patients was poor(DQ＜85), with the poor prognosis rate of 40.5%(15/37).4) The prognosis rate of mild, moderate and severe VEEG patients was about 11.1%, 60.0% and 77.8%, respectively.The consistency test of Kappa between the degree of VEEG abnormality and GDS was 0.60.The sensitivity and specificity of predicting the degree of VEEG abnormality were 86.7%, 72.7%, positive predictive value of 68.4% and negative predictive value of 88.9%. Conclusions The predictive value of VEEG and GDS test in neonatal convulsions is not completely consistent.VEEG has high sensitivity and negative predictive value in predicting prognosis, but low specificity and positive predictive value.Clinically, it often takes a long time for comprehensive evaluation to make a more accurate judgment on the neurodevelopment of children with seizures.