怀疑癫痫的儿童首次脑电图的诊断率：清醒和睡眠记录之间的回顾性年龄相关比较

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice Pub Date : 2025-01-01 DOI:10.1016/j.cnp.2025.05.002

Greta Gustafsson , Anders Broström , Eva Svanborg , Magnus Vrethem , Martin Ulander

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引用次数: 0

摘要

目的以往的研究表明，早期脑电图在儿童癫痫诊断中的诊断率较低。本研究旨在探讨影响不同年龄段首次脑电图诊断率的因素，以及影响脑电图方法选择的因素。方法回顾性分析1097例疑似癫痫患儿首次记录的脑电图，并将其分为≤5岁、6 ~ 11岁和12 ~ 17岁年龄组。脑电图分为有或没有刺激的清醒记录和睡眠记录：自发睡眠、剥夺睡眠或褪黑素预用药引起的睡眠。结果有18%的患者有尿样活性，其中以6-11岁儿童最为常见（30%）。与其他类型的睡眠脑电图相比，褪黑激素诱发的睡眠脑电图更容易检测到它。癫痫样放电的存在与所有儿童的年龄、睡眠、神经和/或智力合并症呈正相关。结论癫痫样活动的发生率随儿童年龄的不同而不同。睡眠脑电图是有利的第一次记录，特别是在非常年幼的儿童或有神经系统合并症。意义褪黑素诱发的睡眠脑电图与其他类型的睡眠脑电图相比具有更高的诊断率。年龄、癫痫符号学和合并症影响脑电图方法的选择。

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The diagnostic yield of a first EEG in children with suspected epilepsy: A retrospective age-related comparison between awake and sleep recordings

Objectives

Previous research has indicated a low diagnostic yield of initial EEGs in epilepsy diagnosis in children. This study aimed at exploring factors affecting the diagnostic yield of a first EEG in different ages, and factors affecting the choice of EEG method.

Methods

1097 EEGs performed as first recordings in children with suspected epilepsy were retrospectively analysed and divided into age groups: ≤ 5, 6–11 and 12–17 years. EEGs were classified as wake recordings with or without provocations, and sleep recordings: spontaneous sleep, sleep induced by deprivation or by melatonin premedication.

Results

Epileptiform activity was found in 18 % of all patients, most common (30 %) in children 6–11 years old. It was more likely to be detected in melatonin-induced sleep EEGs compared to other types of sleep EEG. Presence of epileptiform discharges were positively associated to age, sleep, neurological and/or intellectual comorbidity in all children.

Conclusions

The prevalence of epileptiform activity varies depending on the child́s age. Sleep EEG is advantageous as first recording, especially in very young children or with neurological comorbidity.

Significance

Melatonin-induced sleep EEG has higher diagnostic yield compared to other types of sleep EEG. Age, seizure semiology and comorbidity affect the choice of EEG method.

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来源期刊

Clinical Neurophysiology Practice NEUROSCIENCES-

CiteScore

3.90

自引率

0.00%

发文量

审稿时长

71 days

期刊介绍： Clinical Neurophysiology Practice (CNP) is a new Open Access journal that focuses on clinical practice issues in clinical neurophysiology including relevant new research, case reports or clinical series, normal values and didactic reviews. It is an official journal of the International Federation of Clinical Neurophysiology and complements Clinical Neurophysiology which focuses on innovative research in the specialty. It has a role in supporting established clinical practice, and an educational role for trainees, technicians and practitioners.