Does sleep or sleep deprivation increase epileptiform discharges in pediatric electroencephalograms?
Does sleep or sleep deprivation increase epileptiform discharges in pediatric electroencephalograms?
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DOI：
10.1542/peds.2003-0612-l
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发表时间：
2004-09-01
期刊：
影响因子：
8
通讯作者：
Bare, MA
中科院分区：
文献类型：
--
作者：
Gilbert, DL;DeRoos, S;Bare, MA
目标。在获得脑电(EEG)之前睡眠不足被认为既增加了在EEG期间睡眠的可能性，也增加了对发作期癫痫样放电的检测。然而，剥夺孩子的睡眠对父母和孩子都是一种负担。本研究的目的是比较睡眠、标准睡眠剥夺、部分睡眠剥夺和不睡眠剥夺对儿科门诊患者癫痫样异常发生率的影响。数据收集自两个两个月期间在繁忙的大学神经学实践中进行的所有儿科脑电图。在第一阶段，所有的脑电图都按顺序进行，要么是标准睡眠剥夺(SSD)，要么是非睡眠剥夺(NSD)。在接下来的2个月中，按常规进行SSD脑电图检查。然而，非SSD家庭被指示让他们的孩子在EEG前一晚2小时后保持清醒。那些遵守规定的人被归类为部分睡眠剥夺(PSD)。将患者特征与CHI(2)和适当的方差检验分析进行比较。用Logistic回归分析计算与睡眠、NSD、PSD和SSD脑电相关的癫痫样改变和异常发现的几率。在820个符合条件的脑电中，22%的NSD、44%的PSD和57%的SSD脑电发生睡眠。这项研究的样本大小允许85%的功率，阿尔法为0.05，以检测绝对增加的脑电产量10%。睡眠的存在(优势比[OR]：0.99；95%可信区间[CI]：0.69-1.42)和使用PSD(OR：0.90；95%CI：0.50-1.62)或SSD(OR：0.96；95%CI：0.63-1.47)都不会增加癫痫样EEG的发生几率。睡眠剥夺不应该被常规地用于增加儿科脑电的产量。
Objective. Sleep deprivation before obtaining an electroencephalogram (EEG) is believed both to increase the likelihood of sleep during an EEG and to increase the detection of interictal epileptiform discharges. However, depriving a child of sleep poses a burden on both the parent and the child. The objective of this study was to compare the effects of sleep, standard sleep deprivation, partial sleep deprivation, and no sleep deprivation on the odds of an epileptiform abnormality in outpatient pediatric EEGs.Methods. Data were collected from all pediatric EEGs performed at a busy, university-based neurologic practice during two 2-month periods. During the first period, all EEGs were performed as ordered, either standard sleep-deprived (SSD) or non-sleep-deprived (NSD). During the second 2 months, SSD EEGs were performed per routine. However, non-SSD families were instructed to keep their children awake 2 hours later the night before the EEG. Those who complied were classified as partially sleep-deprived (PSD). Patient characteristics across protocols were compared with chi(2) and analysis of variance tests as appropriate. The odds of epileptiform and abnormal findings associated with sleep, NSD, PSD, and SSD EEGs were calculated using logistic regression.Results. Of 820 eligible EEGs, sleep occurred in 22% of NSD, 44% of PSD, and 57% of SSD EEGs. The sample size of this study allowed for an 85% power, with alpha of .05, to detect an absolute increased EEG yield of 10%. Neither the presence of sleep (odds ratio [OR]: 0.99; 95% confidence interval [CI]: 0.69-1.42) nor the use of PSD ( OR: 0.90; 95% CI: 0.50-1.62) or SSD (OR: 0.96; 95% CI: 0.63-1.47) protocols increased the odds of epileptiform EEGs.Conclusions. Sleep deprivation should not be used routinely to increase the yield of pediatric EEGs.