Acute EEG findings in children with febrile status epilepticus Results of the FEBSTAT study
Acute EEG findings in children with febrile status epilepticus Results of the FEBSTAT study
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DOI：
10.1212/wnl.0b013e3182759766
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发表时间：
2012-11-01
期刊：
影响因子：
9.9
通讯作者：
Sun, Shumei
中科院分区：
文献类型：
--
作者：
Nordli, Douglas R., Jr.;Moshe, Solomon L.;Sun, Shumei
目的：FEBSTAT（长期热性癫痫发作的后果）研究前瞻性地探讨了一组儿童自出现发热性癫痫持续状态 (FSE) 以来的连续脑电图、MRI 和临床随访之间的关系。方法：我们招募了 199 名在出现发热性癫痫持续状态 (FSE) 后 72 小时内患有 FSE 的儿童。儿童在 72 小时内接受了详细的病史、体格检查、MRI 和脑电图检查。所有脑电图均由 2 个团队读取，然后进行会议。使用逻辑回归确定与异常脑电图的关联。使用 kappa 统计数据评估受试者内可靠性。结果：在 199 个脑电图中，90 个（45.2%）异常，最常见的异常是局灶减慢（n = 47）或衰减（n = 25）；几乎在所有情况下，这些在颞区都是最大的。 13 例脑电图 (6.5%) 存在癫痫样异常。在调整分析中，局灶性减慢的几率因局灶性 FSE（优势比 [OR] = 5.08）和海马 T2 信号异常（OR = 3.50）而显着增加，并因高峰值温度而显着降低（OR = 0.18）。局灶性脑电图衰减也与海马 T2 信号异常相关（OR = 3.3）。结论：相当一部分儿童在 FSE 72 小时内获得的脑电图存在局灶性脑电图减慢或衰减，并且与急性海马损伤的 MRI 证据高度相关。这些发现可能是与 FSE 相关的急性损伤的敏感且容易获得的标志。神经病学（R）2012；79：2180-2186
Objective: The FEBSTAT (Consequences of Prolonged Febrile Seizures) study is prospectively addressing the relationships among serial EEG, MRI, and clinical follow-up in a cohort of children followed from the time of presentation with febrile status epilepticus (FSE).Methods: We recruited 199 children with FSE within 72 hours of presentation. Children underwent a detailed history, physical examination, MRI, and EEG within 72 hours. All EEGs were read by 2 teams and then conferenced. Associations with abnormal EEG were determined using logistic regression. In-terrater reliability was assessed using the kappa statistic.Results: Of the 199 EEGs, 90 (45.2%) were abnormal with the most common abnormality being focal slowing (n = 47) or attenuation (n = 25); these were maximal over the temporal areas in almost all cases. Epileptiform abnormalities were present in 13 EEGs (6.5%). In adjusted analysis, the odds of focal slowing were significantly increased by focal FSE (odds ratio [OR] = 5.08) and hippocampal T2 signal abnormality (OR = 3.50) and significantly decreased with high peak temperature (OR = 0.18). Focal EEG attenuation was also associated with hippocampal T2 signal abnormality (OR = 3.3).Conclusions: Focal EEG slowing or attenuation are present in EEGs obtained within 72 hours of FSE in a substantial proportion of children and are highly associated with MRI evidence of acute hippocampal injury. These findings may be a sensitive and readily obtainable marker of acute injury associated with FSE. Neurology (R) 2012;79:2180-2186