Value of the electroencephalogram in adult patients with untreated idiopathic first seizures.
Value of the electroencephalogram in adult patients with untreated idiopathic first seizures.
复制标题
脑电图对未经治疗的特发性首次癫痫发作的成人患者的价值。
作者：
C. V. van Donselaar;R. Schimsheimer;A. Geerts;A. Declerck
我们前瞻性地研究了脑电图作为预测157例未经治疗的特发性首次发作患者2年内复发风险的可靠性和准确性。对所有患者进行标准脑电图检查，必要时进行部分睡眠剥夺后的脑电图检查。所有的脑电图由一名观察员按照固定的方案评分。癫痫性放电与复发风险相关：83%(95%可信区间，69% ~ 97%)，非癫痫性异常患者为41%(95%可信区间，29% ~ 53%)，两种脑电图均正常的患者为12%（95%可信区间，3% ~ 21%）。灵敏度为48%。在独立阅读了50份脑电图的4位神经学家之间，观察者之间的一致性是中等的。然而，每个观察者的预测价值都很好。我们的结论是，脑电图结果可能在特发性首次发作后开始或延迟治疗的决定中发挥作用。
We prospectively studied the reliability and accuracy of the electroencephalogram as a predictor of the risk of recurrence within 2 years in 157 patients with untreated idiopathic first seizures. In all patients, a standard electroencephalogram and, if necessary, an electroencephalogram after partial sleep deprivation were obtained. All electroencephalograms were scored by one observer according to a fixed protocol. The finding of epileptic discharges was associated with a risk of recurrence of 83% (95% confidence interval, 69% to 97%) vs 41% (95% confidence interval, 29% to 53%) in patients with nonepileptic abnormalities and 12% (95% confidence interval, 3% to 21%) in patients in whom both electroencephalograms were normal. The sensitivity proved to be 48%. Interobserver agreement among four neurologists, who independently read 50 electroencephalograms, was found to be moderate. Predictive value for each observer, however, was good. We conclude that electroencephalogram findings may play a role in the decision to initiate or delay treatment after an idiopathic first seizure.