Consciousness of seizures and consciousness during seizures: are they related?
Consciousness of seizures and consciousness during seizures: are they related?
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DOI：
10.1016/j.yebeh.2013.09.018
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发表时间：
2014-01
期刊：
影响因子：
--
通讯作者：
Blumenfeld H
中科院分区：
文献类型：
--
作者：
Detyniecki K;Blumenfeld H
最近在癫痫发作时意识损害的网络机制方面取得了进展。然而，患者对自己癫痫发作的意识却知之甚少。研究患者癫痫发作的报告或文献是目前最常用的机制来科学地测量患者癫痫发作的意识。本综述的目的是总结有关患者癫痫发作计数准确性的现有证据，并确定可能影响不可靠的癫痫发作报告的变量。几个研究小组在连续脑电图监测期间观察患者癫痫发作的记录，发现患者报告的癫痫发作次数不多达50%。这些研究还表明，伴有意识丧失的癫痫发作，发生在左半球或颞叶，或发生在睡眠期间，与报告数量显著减少有关。基线记忆性能似乎对癫痫发作报告的准确性没有重大影响。为了更充分地了解癫痫少报的机制，需要进一步的前瞻性研究，包括使用经过验证的关键行为测试，以及使用新的电生理和神经成像技术进行癫痫发作定位的相关研究。目前正在研究更好的方法来提醒护理人员注意未被识别的癫痫发作，并改善癫痫发作的记录。本文是《癫痫与意识》特刊的一部分。
Recent advances have been made in the network mechanisms underlying impairment of consciousness during seizures. However, less is known about patient awareness of their own seizures. Studying patient reports or documentation of their seizures is currently the most commonly utilized mechanism to scientifically measure patient awareness of seizures. The purpose of this review is to summarize the available evidence regarding the accuracy of patient seizure counts and identify the variables that may influence unreliable seizure reporting. Several groups looking at patient documentation of seizures during continuous EEG monitoring show that patients do not report as many as 50% of their seizures. These studies also suggest that seizures accompanied by loss of consciousness, arising from the left hemisphere or the temporal lobe, or occurring during sleep are associated with significantly reduced reporting. Baseline memory performance does not appear to have a major influence on the accuracy of seizure report. Further prospective studies using validated ictal behavioral testing as well as using correlation with newer electrophysiological and neuroimaging techniques for seizure localization are needed to more fully understand the mechanisms of underreporting of seizures. Better methods to alert caregivers about unrecognized seizures and to improve seizure documentation are under investigation. This article is part of a Special Issue entitled Epilepsy and Consciousness.
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DOI：
10.1016/s1474-4422(12)70188-6
发表时间：
2012-09
期刊：
The Lancet. Neurology
影响因子：
--
作者：
Blumenfeld H
通讯作者：
Blumenfeld H
影响因子：
5.6
作者：
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通讯作者：
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影响因子：
--
作者：
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通讯作者：
Radtke, RA
影响因子：
2.6
作者：
Pavlova, MK;Shea, SA;Bromfield, EB
通讯作者：
Bromfield, EB
影响因子：
14.5
作者：
Englot, Dario J.;Yang, Li;Blumenfeld, Hal
通讯作者：
Blumenfeld, Hal