Epilepsy - Accuracy of patient seizure counts
Epilepsy - Accuracy of patient seizure counts
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DOI：
10.1001/archneur.64.11.1595
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发表时间：
2007-11-01
影响因子：
--
通讯作者：
Elger, Christian E.
中科院分区：
文献类型：
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作者：
Hoppe, Christian;Poepel, Annkathrin;Elger, Christian E.
目的：评估每日患者提醒对癫痫发作documentation accuracy.Design的影响：随机对照试验。设置：监测单位的学术部门epileptology.Patients：concentive样本的91例成人住院患者进行视频脑电图监测局灶性癫痫。干预措施：虽然所有患者被要求记录癫痫发作在开始的监测期，从实验组的患者每天提醒文件seizures.Main Outcome Measure：文件的准确性（记录癫痫发作的百分比）。患者未能记录所有记录的癫痫发作的55.5%，73.2%的复杂部分性癫痫发作，26.2%的简单部分性癫痫发作，41.7%的继发性全身强直阵挛性癫痫发作，85.8%的所有癫痫发作在睡眠期间，32.0%的所有癫痫发作在清醒状态。总体癫痫发作、简单部分性癫痫发作、复杂部分性癫痫发作和继发性全身强直阵挛性癫痫发作的个体记录准确性的组中位数分别为33.3%、66.7%、0%和83.3%。患者提醒和认知表现均不影响记录准确性。左侧脑电图的重点或病变，但不是网站（额或颞），促成文件failure.Conclusions：患者癫痫发作计数不提供有效的信息。记录失败的原因是癫痫发作后的无意识，这是无法避免的提醒。在临床试验中使用患者癫痫发作计数的前提条件是文件准确性保持不变，并且必须在接受脑电图监测的患者子样本中进行证明。
Objective: To evaluate the effects of a daily patient reminder on seizure documentation accuracy.Design: Randomized controlled trial.Setting: Monitoring unit of an academic department of epileptology.Patients: Consecutive sample of 91 adult inpatients with focal epilepsies undergoing video-electroencephalographic monitoring. Intervention: While all patients were asked to document seizures at the beginning of the monitoring period, patients from the experimental group were reminded each day to document seizures.Main Outcome Measure: Documentation accuracy (percentage of documented seizures).Results: A total of 582 partial seizures were recorded. Patients failed to document 55.5% of all recorded seizures, 73.2% of complex partial seizures, 26.2% of simple partial seizures, 41.7% of secondarily generalized tonic-clonic seizures, 85.8% of all seizures during sleeping, and 32.0% of all seizures during the awake state. The group medians of individual documentation accuracies for overall seizures, simple partial seizures, complex partial seizures, and secondarily generalized tonic-clonic seizures were 33.3%, 66.7%, 0%, and 83.3%, respectively. Neither the patient reminder nor cognitive performance affected documentation accuracy. A left-sided electroencephalographic focus or lesion, but not the site (frontal or temporal), contributed to documentation failure.Conclusions: Patient seizure counts do not provide valid information. Documentation failures result from postictal seizure unawareness, which cannot be avoided by reminders. Unchanged documentation accuracy is a prerequisite for the use of patient seizure counts in clinical trials and has to be demonstrated in a subsample of patients undergoing electroencephalographic monitoring.