Generalized Periodic Discharges With and Without Triphasic Morphology
Generalized Periodic Discharges With and Without Triphasic Morphology
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DOI：
10.1097/wnp.0000000000000441
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发表时间：
2018-03-01
影响因子：
2.4
通讯作者：
Luders, Hans O.
中科院分区：
文献类型：
--
作者：
Alkhachroum, Ayham M.;Al-Abri, Haifa;Luders, Hans O.
目的：具有三相形态的全身性周期性放电（GPD）与非癫痫性脑病有关。我们进行了这项研究，以评估的可靠性，脑电图可以区分三相和非三相周期性放电，并评估存在的脑电图和临床特征，与癫痫发作的风险较高。方法：我们前瞻性研究了2016年5月至2017年2月之间的92例患者。每个模式进行了分析，由两个读者，谁是盲目的临床data.Results：评价者之间的协议是“实质性的”（Kappa 0.67）。以下特征显著增加了癫痫发作的风险：三相形态的缺失、脑电图上的病灶、爆发间抑制、癫痫病史和异常扫描。“GPD评分”包括癫痫病史、脑电图病灶和三相形态缺失。0分的GPD有13%的癫痫发作的风险，而5至6分有94%的risk.Conclusions：三相形态GPD赋予癫痫发作的风险较低，与GPD患者相比，没有三相形态。具有较高癫痫发作风险的特征包括脑电图上的局灶性、爆发间抑制、癫痫病史和异常扫描。GPD评分可用于评估GPD患者发生癫痫发作的风险。
Purpose: Generalized periodic discharges (GPDs) with a triphasic morphology have been associated with nonepileptic encephalopathies. We conducted the study to assess the reliability in which electroencephalographers can differentiate triphasic from nontriphasic periodic discharges and to evaluate for the presence of electroencephalogram and clinical characteristics that are associated with a higher risk of seizures.Methods: We studied prospectively 92 patients between May 2016 and February 2017. Each pattern was analyzed by two readers, who were blinded to clinical data.Results: The interrater agreement was "substantial" (Kappa 0.67). The following features significantly increased the risk of developing seizures: the absence of triphasic morphology, focality on electroencephalogram, interburst suppression, a history of epilepsy, and an abnormal scan. The "GPD score" includes a history of epilepsy, focality on electroencephalogram, and the absence of triphasic morphology. A GPD score of 0 has 13% risk of seizures, whereas a score of 5 to 6 has a 94% risk.Conclusions: Triphasic morphology GPDs confer less risk of seizures when compared with patients with GPDs without triphasic morphology. Features with a higher risk of seizures include focality on electroencephalogram, interburst suppression, a history of epilepsy, and an abnormal scan. The GPD score can be used to assess the risk of developing seizures in patients with GPDs.