- 期刊
神經學檢查正常之頭痛病人，腦電圖檢查有用嗎？－與頭部電腦斷層攝影掃描所得結果之比較－
In Headache Patients with Normal Neurologic Findings, is EEG a Useful Screen Test? As Compare to CT Findings
摘要
神經學檢查正常的頭痛病人，其顱內不一定正常。因目前醫療費用昂貴，故我們不能為了不遺落這些少數顱內異的病人，而安排每位病人都做種種檢查如腦電圖或頭部電腦斷層攝影。本文的目的在於探討神經學檢查正常之各類頭痛病人，先做腦電圖檢查是否恰當，是否可以提示我們何種情況該做頭部電腦斷層攝影。在分析80位神經學檢查正常之頭痛病人的腦電圖和頭部電腦斷層攝影以後，確定腦電圖不是一個有效的篩檢工具。因此我們建議臨床醫師對頭痛的病人必須先做詳細的病史問診以及神經學檢查，以排除顱內結構性病變所致的疾病。若病人神經學檢查正常時，不必做EEG以減少醫療浪費。但是仍應對病人說明顱內疾病(例如顱內血管異常、慢性硬腦膜下血腫塊和腦部不產生神經學徵象區的病變)可能出現的症狀。若病人出現這些症狀時，則應接受CT或其他特殊檢查。
關鍵字
無資料並列摘要
Eighty patients with various headache syndromes but without focal neurologic findings were studied for assessing the correlation between the CT and EEG findings and for determining the usefulness of EEG on the care of headache patients. The yield of focal CT abnormalities was significantly higher in the patients with focal EEG abnormalities than in those with other types of abnormal records (p=0.014). But a rare occurrence of focal EEG abnormalities among headache patients with no focal neurologic findings (2.5%) and the low sensitivity of EEG examination (20%) indicated that EEG is not a useful screen test. Ten of eighty patients were found to have focal CT abnormalities including intracranial vascular anomalies (4 cases), chronic subdural hematomas (2 cases) and silent brain lesions (4 cases). EEG examination is not recommended in headache patients with normal neurologic findings. A close follow-up is advised for fear of the possibility of underlying intracranial vascular anomaly, chronic subdural hematoma or silent brain lesion. If any clinical symptoms and signs appear thereafter, CT scanning would be necessary.