Recommendations regarding the requirements and applications for long-term recordings in epilepsy
Recommendations regarding the requirements and applications for long-term recordings in epilepsy
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DOI：
10.1111/j.1528-1167.2007.00920.x
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发表时间：
2007-02-01
期刊：
影响因子：
5.6
通讯作者：
Lopes da Silva, Fernando
中科院分区：
文献类型：
--
作者：
Velis, Demetrios;Plouin, Perrine;Lopes da Silva, Fernando
本文的目的是更新知识状态方面的长期监测（LTM）在癫痫和制定有关的应用LTM在临床实践中的建议。LTM是一种既在医院环境中使用，又越来越多地在门诊环境中使用，最近又在社区环境中使用的成熟技术。已经有足够的证据证明，LTM是至关重要的记录电临床相关性在癫痫和阵发性发生的行为变化往往被误认为癫痫的索赔。国际公认的神经生理设备标准、数据采集和数据传输协议以及广泛接受的安全标准使癫痫患者广泛使用LTM设施成为可能。已经制定了关于高效和有效利用资源以及参与癫痫LTM的人员培训和能力的建议。ILAE的DMC神经生理学小组委员会建议在记录癫痫发作时使用基于医院的LTM，包括其在评估癫痫发作类型和频率、评估癫痫持续状态、癫痫手术的无创和有创视频/EEG检查以及儿童和成人癫痫和阵发性非癫痫疾病之间的鉴别诊断中的应用。在住院LTM不具有成本效益或不可行的情况下，或在不适用旨在增加癫痫发作率的激活程序的情况下，门诊和社区LTM可用作住院LTM的替代品。然而，在某些情况下，门诊患者动态监测的信息量可能比住院患者监测的信息量少，因为：（1）减少引起癫痫发作的药物治疗可能对门诊患者不安全;（2）无法快速注意到和修复电极接触故障;（3）患者可能会离开视频监控;以及（4）动态监测的持续时间可能受到技术限制。
The purpose of this paper is to update the state of knowledge with respect to long-term monitoring (LTM) in epilepsy and to formulate recommendations regarding the application of LTM in clinical practice. LTM is an established technique in use both in a hospital setting and, increasingly, in an ambulatory and more recently in a community-based setting. There has been sufficient evidence to substantiate the claim that LTM is of crucial importance in documenting electroclinical correlations both in epilepsy and in paroxysmally occurring behavioral changes often mistaken for epilepsy. Internationally recognized neurophysiological equipment standards, data acquisition and data transfer protocols and widely accepted safety standards have made widespread access to LTM facilities in epilepsy possible. Recommendations on efficient and effective use of resources as well as regarding training and competencies for personnel involved in LTM in epilepsy have been formulated. The DMC Neurophysiology Subcommittee of the ILAE recommends use of hospital-based LTM in the documentation of seizures including its application for assessing seizure type and frequency, in the evaluation of status epilepticus, in noninvasive and invasive video/EEG investigations for epilepsy surgery and for the differential diagnosis between epilepsy and paroxysmally occurring nonepileptic conditions, in children and in adults. Ambulatory outpatient and community-based LTM may be used as a substitute for inpatient LTM in cases where the latter is not cost-effective or feasible or when activation procedures aimed at increasing seizure yield are not indicated. However, outpatient ambulatory monitoring may be less informative than is inpatient monitoring in some cases because: (1) reduction of medication to provoke seizures may not be safe as an outpatient; (2) faulty electrode contacts cannot quickly be noticed and repaired; (3) the patient may move out of video surveillance; and (4) duration of ambulatory monitoring can be limited by technical constraints.