A method for the diagnosis of epilepsy

 

(57) Abstract:

The invention relates to medicine, namely, neurology, and can be used for the diagnosis of paroxysmal States epileptic and nonepileptic Genesis. Spend stimulation reversing checkerboard pattern and the registration of induced visual potentials. Determine the amplitude of the rhythmic polarised as the average of the amplitudes of the peaks of the potential difference in the range of 400-1000 MS during stimulation of the separate right and left eye. Additionally calculate the critical value of the amplitude of polarized (AK) in Áv according to the formula: Ato= TO ANP100where atocritical value of the amplitude of polarized, Áv, K - factor, equal to 0.61, AND NP100- the average value of the amplitude of the positive component R in healthy subjects, MKV, compare the values and, if the average amplitude of polarized higher than the critical value, establish the diagnosis of epilepsy. The method improves the accuracy of diagnosis.

The invention relates to the field of neurology and can be used for the diagnosis of paroxysmal States epileptic and nonepileptic Genesis, in particular, ill. unctionally diagnosis of nervous diseases. M.: Medicine, 1991, S. 293 - 304), which is in registration are visual evoked potentials (SGP) of the cerebral cortex in 8-lead located at symmetric points in the occipital, parietal, Central and frontal areas in response to visual stimulation with a flash of light, which is supplied to the closed eyes studied from a distance of 30 cm with subsequent visual quality rating components VIZ for epilepsy patients based on the presence or absence of increasing amplitude and shape changes of the potential of converting it into a complex peak-wave. The presence of increasing amplitude and a transformation of the form of the potential was regarded as a sign of epilepsy, and the absence of these changes was regarded as a sign of lack of epileptic disorders.

However, this method does not provide accurate diagnosis of epilepsy, as assessed VIZ without quantifying the exact criteria of presence of epileptic disorders.

The task of the invention is to improve the accuracy of diagnosis of paroxysmal States in patients with ischemic stroke in order to timely identify the decision accuracy of diagnosis.

The technical result is achieved in that in the method for the diagnosis of epilepsy, including visual stimulation reversing checkerboard pattern with the size of the cells 30' and the light patter of 60 kJ/m2then determine the average amplitude of polarized as the arithmetic average of the amplitudes of the peaks in the potential difference between the active electrode placed in the Central occipital point, and a reference electrode located in sredneobsky point in the range of 400-1000 MS during stimulation of the separate right and left eye, and comparing the obtained value with a critical value of the amplitude of polarized, which is calculated by the formula

AK=KANP100,

where AK is a critical value of the amplitude of polarized, Áv;

K - coefficient, equal to 0.61;

ANDNP100- the average value of the amplitude of the main positive component R in healthy subjects, Laq,

thus, if the average amplitude of polarized higher than the critical value, then establish the diagnosis of epilepsy.

The method is as follows. A survey carried out on the device for recording evoked potentials, in particular Conterpoint ("Dantec Medtronic, US. USA-Denmark). The patient impose an active electrode in the center of the frontal point-Fz. (Zenkov L. R. , Ronkin, M. A., 1991. lliday A., 1982). Then spend a full screen monocular stimulation reversing checkerboard patter (separate left and right eye). In accordance with standard procedure (alliday A. Evoked potentials in clinical testing. Edinburg et.c: Churchill Liningstone, 1982, 575 p.) the frequency of treatment of a putter is 1 Hz, the size of the cells 30', the average brightness of the screen - 60 kJ/m2the number of averagings - 100. Epoch analysis is 1000 MS.

Defined components VIZ-R, 145, P200, 250, and then touch polarized in the range of 400-1000 MS. The average amplitude of polarized is determined by calculating the average value of the amplitudes of the ten most pronounced component of polarized (after the main peaks actually PEL - P200, 250, i.e., starting with 400 MS). Then calculated the arithmetic mean of the amplitudes of polarized obtained during stimulation of the separate right and left eyes.

If the amplitude of polarized value is larger than the critical value of the amplitude AK, these changes are consistent with epilepsy.

Taking into account the individual characteristics of the devices developed system of calculation of the threshold amplitude polarized by the formula: AK = KANP100where AK is the desired level of cu is NP100 - the average value of the amplitude of the main positive component R in healthy subjects (obtained in the study of this particular device), calculated as the arithmetic mean of the amplitudes R obtained by separate stimulation of the right and left eye (for our device, this value amounted to 6.377 Áv).

Example 1.

Patient P., 53.

The diagnosis of encephalopathy with 3 tbsp. residual moved ischemic stroke in the left hemisphere of the brain. Symptomatic locally due to epilepsy.

From the anamnesis it is known that in 1994, he suffered a cerebral blood flow in ischemic type in the cortical branches of the left middle cerebral artery, with a slight paresis in the right limbs, and items of motor aphasia with incomplete recovery. 8 months after a stroke, the patient developed sudden attack of vertigo, followed by loss of consciousness. Ill attack was antinovel.

When viewed in the neurological status was observed: cerebral and meningeal symptoms are not present. Acuity and field of view approximately not changed. Movement of the eyeballs in full. Eyes rounded D = S. O. Mild right-sided hemiparesis to 4.5 points. Muscle tone in the right extremities slightly elevated by spastic type. Tendon and periosteal reflexes D > S, the symptom Babinski on the right. Sensitivity is not compromised. Coordinatorsee sample performs satisfactorily.

The proposed method after the registration of the PEL for noise reduction in the hardening 0zwas identied according to the results of stimulation of the right and left eye And polarized, which was 7,12 Áv. Since this value exceeds the critical AK= 0,61 7,377 = 2,09 Áv, was diagnosed with epilepsy. Further observation of the patient and re-EEG confirmed the diagnosis.

The proposed method was examined 120 patients with post-stroke epilepsy and patients with ischemic stroke and in 80 cases diagnosed epilepsy.

A method for the diagnosis of epilepsy, including the assessment of the visual analyzer through visual stimulation and registration of induced visual potentials, characterized in that the conduct stimulation of the reversing checkerboard pattern with the size of the cells 30' and the illumination pattern 60 kJ/m2then determine the average amplitude Posleen in the Central occipital point, in the range of 400-1000 MS during stimulation of the separate right and left eye, and comparing the obtained value with a critical value of the amplitude of polarized, which is calculated by the formula:

ANDto= TO ANP100,

where atocritical value of the amplitude of polarized, Áv;

K - coefficient, equal to 0.61;

ANDNP100- the average value of the amplitude of the positive component R in healthy subjects, Laq,

thus, if the average amplitude of polarized higher than the critical value, then set the diagnosis "epilepsy".

 

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