How Seizure Detection by Continuous Electroencephalographic Monitoring Affects the Prescribing of Antiepileptic Medications
How Seizure Detection by Continuous Electroencephalographic Monitoring Affects the Prescribing of Antiepileptic Medications
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DOI：
10.1001/archneurol.2009.100
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发表时间：
2009-06-01
影响因子：
--
通讯作者：
Chiappa, Keith H.
中科院分区：
文献类型：
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作者：
Kilbride, Ronan D.;Costello, Daniel J.;Chiappa, Keith H.
目的：评估连续脑电图监测对住院患者癫痫发作治疗决策的影响，特别是在重症监护室。设计：回顾性队列研究。设定：医学和神经科学重症监护病房和神经科病房。患者：300个连续的非选择性连续脑电图监测研究，在27个月内对287名住院患者进行。主要结果测量：癫痫样脑电图异常和基于脑电图结果的抗癫痫药物（AED）治疗的变化。结果：连续脑电图监测的结果导致52%的研究改变了AED处方，14%的研究开始AED治疗，33%的研究修改了AED治疗，5%的研究停止了AED治疗。具体而言，检测脑电图癫痫发作导致AED治疗的变化在28%的所有study.Conclusions：结果连续脑电图监测导致AED处方的变化期间或之后进行的研究的一半。大多数AED的变化是由于检测到电描记癫痫发作。神经弓2009;66（6）：723-728
Objectives: To assess the effect of continuous electroencephalographic monitoring on the decision to treat seizures in the inpatient setting, particularly in the intensive care unit.Design: Retrospective cohort study. Setting: Medical and neuroscience intensive care units and neurological wards.Patients: Three hundred consecutive nonelective continuous electroencephalographic monitoring studies, performed on 287 individual inpatients over a 27-month period.Main Outcome Measures: Epileptiform electroencephalographic abnormalities and changes in antiepileptic drug (AED) therapy based on the electroencephalographic findings.Results: The findings from the continuous electroencephalographic monitoring led to a change in AED prescribing in 52% of all studies with initiation of an AED therapy in 14%, modification of AED therapy in 33%, and discontinuation of AED therapy in 5% of all studies. Specifically, the detection of electrographic seizures led to a change in AED therapy in 28% of all studies.Conclusions: The findings of continuous electroencephalographic monitoring resulted in a change in AED prescribing during or after half of the studies performed. Most AED changes were made as a result of the detection of electrographic seizures. Arch Neurol. 2009;66(6):723-728