The relationship of interictal epileptiform discharges to clinical epilepsy severity: a study of routine electroencephalograms and review of the literature.
The relationship of interictal epileptiform discharges to clinical epilepsy severity: a study of routine electroencephalograms and review of the literature.
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DOI：
10.1097/wnp.0b013e3181d64b1e
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发表时间：
2010-04
期刊：
影响因子：
--
通讯作者：
Chang BS
中科院分区：
文献类型：
--
作者：
Selvitelli MF;Walker LM;Schomer DL;Chang BS
脑电图广泛用于检测已知癫痫病史的患者的发作间期癫痫样放电 (IED)。然而，先前的研究尚未发现简易爆炸装置的存在或频率与临床癫痫严重程度之间存在一致的关联，这可能是由于受试者特征和记录技术的差异。我们试图在反映最常见临床用法的人群和环境中调查这种关系。我们分析了所有有至少两次推测局灶性癫痫病史的同意患者的脑电图和临床记录，这些患者在学术神经生理学实验室进行了一年多的常规脑电图记录（n = 129）。尽管有足够的统计能力，但我们没有发现简易爆炸装置的存在或不存在或简易爆炸装置的频率与最近确定的癫痫发作频率（中位数每年 4 次）之间存在关联。癫痫持续时间较长的受试者中 IED 发生率较高 (p = 0.04)。 IED 的发生率和频率（中位数 10.0 次/小时）与年龄或抗癫痫药物的使用无关。我们的结果与之前的一些研究不同，其中大多数研究集中于更狭窄的受试者群体，这表明在假设简易爆炸装置在常规脑电图上预测癫痫严重程度之前必须考虑患者的临床情况。
EEGs are widely used to detect interictal epileptiform discharges (IEDs) in patients with a known history of seizures. However, prior studies have not found a consistent association between the presence or frequency of IEDs and clinical epilepsy severity, possibly because of differences in subject characteristics and recording techniques. We sought to investigate this relationship in a population and setting reflective of the most common clinical usage. We analyzed EEGs and clinical records of all consenting patients with a history of at least two presumed focal-onset seizures who presented for routine EEG recording over one year’s time in an academic neurophysiology laboratory (n = 129). Despite adequate statistical power, we did not find an association between the presence or absence of IEDs or IED frequency and the most recently determined seizure frequency (median 4 per year). A higher IED incidence was seen in subjects with longer epilepsy duration (p = 0.04). Neither IED incidence nor frequency (median 10.0 per hour) correlated with age or antiepileptic drug use. Our results differ from those of some prior studies, most of which focused on more narrow subject populations, suggesting that the patient’s clinical circumstances must be taken into account before assuming the utility of IEDs on routine EEG in predicting epilepsy severity.