儿童热性惊厥病理性脑电图的临床预测因素及其与后续癫痫发作的关系

IF 0.2 Q4 PEDIATRICS

Journal of Pediatric Epilepsy Pub Date : 2021-09-27 DOI:10.1055/s-0041-1736214

K. Kchaou, I. Kammoun, S. Chakroun, A. Haddar, K. Masmoudi

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引用次数: 0

摘要

摘要:本研究的目的是根据至少出现一次发热性癫痫发作(FS)的儿童阵发性脑电图异常与临床特征之间的关系，确定预测病理性脑电图或随后癫痫发作(SES)的临床参数。我们收集了2013年至2018年期间到我科就诊的儿童的数据，用于脑电图记录，作为其热性癫痫发作评估的一部分。仅包括1个月至5岁的儿童。回顾性收集临床和脑电图资料并进行统计学分析。我们对脑电图记录进行了详细分析。对随访充分的患者进行SES鉴定。本研究共纳入120名儿童，其中48%存在脑电图异常。精神运动迟缓(p = 0.002)、最后一次FS发生后7天内完成脑电图(p = 0.046)和首次FS发病的年龄较晚(p = 0.021)与病理性脑电图显著相关。在多变量分析中，早期EEG(距离最后一次FS < 7天)(优势比[OR]: 2.35;p = 0.043;置信区间[CI]: 1.028-5.375)和精神运动迟缓(OR: 4.19;p = 0.008;CI: 1.46-12)是病理性脑电图的独立预测因子。在120名患者中，有45人进行了随访。然而，只有10人(22.22%)患有SES。与非SES儿童相比，SES儿童更倾向于出现精神运动延迟(50% vs. 14.28%， p = 0.029)。有SES的患者初始脑电图异常比例显著高于无SES的患者(70% vs. 34.28%， p = 0.05)。尽管一些FS特征可以预测脑电图异常，但它们并不总是与SES相关。我们强调在患有FS和精神运动迟缓的儿童中进行脑电图的重要性。这很可能是患癫痫风险最高的人群。

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Clinical Predictive Factors of Pathological EEG in Children with Febrile Seizures and Their Association with Subsequent Epileptic Seizures

Abstract The objective of this study was to identify clinical parameters predicting either a pathological EEG or a subsequent epileptic seizure (SES), based on the relation between paroxysmal EEG abnormalities and clinical features in children who presented at least one febrile seizure (FS). We collected data of children who presented to our department during the period 2013 to 2018 for EEG recording as part of their febrile seizure assessment. Only children aged between 1 month to 5 years were included. Both the clinical and EEG data were retrospectively collected and statistically studied. We performed a detailed analysis of the EEG recordings. SES was identified for patients with sufficient follow-up. A total of 120 children were included in the study, of whom 48% had EEG abnormalities. Psychomotor retardation (p = 0.002), completion of an EEG within 7 days of the last FS (p = 0.046), and late age (> 3 years) of the first FS onset (p = 0.021) were significantly associated with a pathological EEG. In multivariate analysis, performing early EEG (< 7 days from the last FS) (odds ratio [OR]: 2.35; p = 0.043; confidence interval [CI]: 1.028–5.375) and psychomotor retardation (OR: 4.19; p = 0.008; CI: 1.46–12) were independent predictors of a pathological EEG. Of 120 patients, 45 had a follow-up. However, only 10 (22.22%) had SES. Children with SES tended more to have a psychomotor delay, compared with children without SES (50% vs. 14.28%, p = 0.029). Moreover, the percentage of initial abnormal EEG in patients with SES was significantly higher than those without SES (70% vs. 34.28%, p = 0.05). Even though some FS characteristics predict EEG abnormalities, they are not always associated with SES. We highlight the importance of performing an EEG in the group of children who had both FS and psychomotor retardation. This is most likely the group at the highest risk of developing epilepsy.

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来源期刊

Journal of Pediatric Epilepsy PEDIATRICS-

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期刊介绍： The Journal of Pediatric Epilepsy is an English multidisciplinary peer-reviewed international journal publishing articles on all topics related to epilepsy and seizure disorders, epilepsy surgery, neurology, neurosurgery, and neuropsychology in childhood. These topics include the basic sciences related to the condition itself, the differential diagnosis, natural history, and epidemiology of seizures, and the investigation and practical management of epilepsy (including drug treatment, neurosurgery and non-medical and behavioral treatments). Use of model organisms and in vitro techniques relevant to epilepsy are also acceptable. Journal of Pediatric Epilepsy provides an in-depth update on new subjects and current comprehensive coverage of the latest techniques used in the diagnosis and treatment of childhood epilepsy.