Comparing Seizures Captured by Rapid Response EEG and Conventional EEG Recordings in a Multicenter Clinical Study.
Comparing Seizures Captured by Rapid Response EEG and Conventional EEG Recordings in a Multicenter Clinical Study.
复制标题
DOI：
10.3389/fneur.2022.915385
复制
发表时间：
2022
影响因子：
3.4
通讯作者：
Parvizi, Josef
中科院分区：
文献类型：
--
作者：
Kurup, Deepika;Gururangan, Kapil;Desai, Masoom J.;Markert, Matthew S.;Eliashiv, Dawn S.;Vespa, Paul M.;Parvizi, Josef
关键词：
最近的一项多中心前瞻性研究（DECIDE试验）检查了Ceribell快速反应脑电图（Rapid-EEG）在疑似有非惊厥发作的危重患者的紧急评估和管理中的应用。我们提出了一项详细的，患者水平的检查，无论是在最初的快速脑电图还是随后的常规脑电图上检测到24小时内的癫痫发作，以调查是否由于排除中线/旁矢状面覆盖而错过了快速脑电图的癫痫发作。我们从164例在DECIDE试验中研究的患者中确定了在快速脑电图中检测到癫痫发作而不是常规脑电图（n = 6），在常规脑电图中检测到癫痫发作而不是快速脑电图（n = 4），或者在快速脑电图和常规脑电图中都检测到癫痫发作（n = 9）。我们检查了两种设备的癫痫发作和发作间的电图特征，特别是在侧或中线/副矢状神经链上的检测，以及患者的临床病史，以确定导致癫痫发作检测不一致的因素。两种脑电图系统检测到的癫痫发作具有相似的电图外观和侧发性。仅在常规脑电图（快速脑电图后24小时内）检测到的癫痫发作在颞链中可见，外部临床因素（例如抗癫痫药物治疗、镇静和记录时间）解释了癫痫发作的延迟表现。仅通过快速脑电图检测到癫痫发作的患者接受抗癫痫药物治疗，随后的常规脑电图检测到间隔期具有相似侧性的高度癫痫样模式。我们的病例系列表明，从最初的快速脑电图和随后的常规脑电图监测中获得的电图数据在形态学和侧边性方面基本一致。这些发现为未来研究简化脑电图系统以优化疑似非惊厥发作和癫痫持续状态的管理提供了宝贵的信息。未来，更大规模的研究可以进一步探讨快速脑电图结果在长期脑电图记录中预测和预测癫痫发作的价值。
A recent multicenter prospective study (DECIDE trial) examined the use of Ceribell Rapid Response EEG (Rapid-EEG) in the emergent evaluation and management of critically ill patients suspected to have non-convulsive seizures. We present a detailed, patient-level examination of seizures detected either on initial Rapid-EEG or subsequent conventional EEG within 24 h to investigate whether seizures were missed on Rapid-EEG due to the exclusion of midline/parasagittal coverage. We identified from 164 patients studied in the DECIDE trial those who had seizures detected on Rapid-EEG but not conventional EEG (n = 6), conventional EEG but not Rapid-EEG (n = 4), or both Rapid-EEG and conventional EEG (n = 9). We examined the electrographic characteristics of ictal and interictal findings on both devices, especially their detection in lateral or midline/parasagittal chains, and patient clinical histories to identify contributors toward discordant seizure detection. Seizures detected on both EEG systems had similar electrographic appearance and laterality. Seizures detected only on conventional EEG (within 24 h following Rapid-EEG) were visible in the temporal chains, and external clinical factors (e.g., treatment with anti-seizure medications, sedation, and duration of recordings) explained the delayed presentation of seizures. Patients with seizures detected only by Rapid-EEG were treated with anti-seizure medications, and subsequent conventional EEG detected interictal highly epileptiform patterns with similar laterality. Our case series demonstrates that electrographic data obtained from initial Rapid-EEG and subsequent conventional EEG monitoring are largely concordant relative to morphology and laterality. These findings are valuable to inform future investigation of abbreviated EEG systems to optimize management of suspected non-convulsive seizures and status epilepticus. Future, larger studies could further investigate the value of Rapid-EEG findings for forecasting and predicting seizures in long-term EEG recordings.
登录
查看更多内容
影响因子：
4.7
作者：
Seeck, Margitta;Koessler, Laurent;Beniczky, Sandor
通讯作者：
Beniczky, Sandor
影响因子：
1.7
作者：
Gururangan, Kapil;Razavi, Babak;Parvizi, Josef
通讯作者：
Parvizi, Josef
影响因子：
3.5
作者：
Young, G. Bryan;Sharpe, Michael D.;Davies-Schinkel, Corrine
通讯作者：
Davies-Schinkel, Corrine
影响因子：
2.4
作者：
Quigg, M;Shneker, B;Domer, P
通讯作者：
Domer, P
影响因子：
5.6
作者：
Beniczky, Sandor;Hirsch, Lawrence J.;Trinka, Eugen
通讯作者：
Trinka, Eugen