门诊脑电图在脑卒中相关急性症状性癫痫患者常规临床护理中的应用。

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Clinical Neurophysiology Pub Date : 2024-05-01 Epub Date: 2023-03-09 DOI:10.1097/WNP.0000000000000992

Pradeep Chandan, Marie E Byrnes, Christopher Newey, Stephen Hantus, Vineet Punia

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引用次数: 0

摘要

目的：卒中后急性症状性癫痫发作（ASyS）是卒中后癫痫（PSE）发病的最高风险因素。我们调查了有 ASyS 问题的中风患者使用门诊脑电图（oEEG）的情况：方法：纳入急性中风、有 ASyS 问题（接受 cEEG 检查）和门诊临床随访的成人（研究人群）。对有 oEEG 的患者（oEEG 队列）进行电图结果分析。单变量和多变量分析有助于确定在常规临床护理中使用 oEEG 的预测因素：在 507 名患者中，83 人（16.4%）接受了 oEEG 检查。使用 oEEG 的独立预测因素包括年龄（OR = 1.03 [1.01 至 1.05，P = 0.01]）、cEEG 上的电图 ASyS（OR 3.9 [1.77 至 8.9]，P < 0.001), ASMs at discharge (OR 3.6 [1.9 to 6.6], P < 0.001), PSE development (OR 6.6 [3.5 to 12.6], P < 0.001), and follow-up duration (OR = 1.01 [1.002 to 1.02], P = 0.016)。近 40% 的 oEEG 患者出现 PSE，但只有 12% 的患者出现癫痫样异常。近四分之一（23%）的oEEG在正常范围内：结论：每六名脑卒中 ASyS 患者中就有一人接受了 oEEG 检查。电图 ASyS、PSE 发展和出院时 ASM 是使用 oEEG 的主要驱动因素。虽然 PSE 推动了 oEEG 的使用，但我们需要对门诊 EEG 作为 PSE 发展预后工具的作用进行系统的前瞻性调查。

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Outpatient EEG in Routine Clinical Care of Patients With Stroke-Related Acute Symptomatic Seizure Concerns.

Purpose: Acute symptomatic seizures (ASyS) after stroke contribute the highest risk to poststroke epilepsy (PSE) development. We investigated the use of outpatient EEG (oEEG) among stroke patients with ASyS concerns.

Methods: Adults with acute stroke, ASyS concerns (underwent cEEG), and outpatient clinical follow-up were included (study population). Patients with oEEG (oEEG cohort) were analyzed for electrographic findings. Univariable and multivariable analyses helped identify predictors of oEEG use in routine clinical care.

Results: Among 507 patients, 83 (16.4%) underwent oEEG. The independent predictors of oEEG utilization included age (OR = 1.03 [1.01 to 1.05, P = 0.01]), electrographic ASyS on cEEG (OR 3.9 [1.77 to 8.9], P < 0.001), ASMs at discharge (OR 3.6 [1.9 to 6.6], P < 0.001), PSE development (OR 6.6 [3.5 to 12.6], P < 0.001), and follow-up duration (OR = 1.01 [1.002 to 1.02], P = 0.016). Almost 40% of oEEG cohort developed PSE, but only 12% had epileptiform abnormalities. Close to a quarter (23%) of oEEGs were within normal limits.

Conclusions: One in six patients with ASyS concern after stroke undergoes oEEG. Electrographic ASyS, PSE development, and ASM at discharge are primary drivers of oEEG use. While PSE drives oEEG use, we need systematic, prospective investigation of outpatient EEG's role as prognostic tool for PSE development.

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来源期刊

Journal of Clinical Neurophysiology 医学-临床神经学

CiteScore

4.60

自引率

4.20%

发文量

198

审稿时长

6-12 weeks

期刊介绍： The Journal of Clinical Neurophysiology features both topical reviews and original research in both central and peripheral neurophysiology, as related to patient evaluation and treatment. Official Journal of the American Clinical Neurophysiology Society.