Characteristics of postictal generalized EEG suppression in children
Characteristics of postictal generalized EEG suppression in children
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DOI：
10.1016/j.eplepsyres.2013.05.007
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发表时间：
2013-09-01
影响因子：
2.2
通讯作者：
Britton, Jeffrey W.
中科院分区：
文献类型：
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作者：
Moseley, Brian D.;So, Elson;Britton, Jeffrey W.
虽然癫痫猝死(SUDEP)的病理生理机制尚不清楚，但自主神经功能障碍被认为是最有可能的。据推测，呼吸抑制导致的SUDEP可能是继发性的后遗症全身性脑电抑制(PGES)。我们试图确定儿童的PGE的特征。这包括前列腺素E是否与ICTIC介导的自主神经改变和潜在的SUDEP风险增加有关。我们的儿科癫痫监测组在2009年3月至2011年10月期间入院的儿童是预期招募的。临床和电生理数据比较了患有和不患有pGES的儿童。数据包括发作期心动过速、心动过缓和低氧血症的发生情况。使用5UDEP-7问卷评分评估潜在的SUDEP风险。对37例儿童168次癫痫发作进行分析。有12/37例(32.4%)患儿在发作后27/168(16.1%)出现PSES。只有原发和继发性全身性强直阵挛发作以pGES为标志。PSES与发作期心动过速(p=0.019)和低氧血症(p=0.005)显著相关。患有PTES的儿童的SUDEP-7问卷得分显著高于未患PTES的儿童(4.2+/-1.3vs 2.8+/-1.4，p=0.007)。有或无发作期心动过速、心动过缓、低氧血症的儿童SUDEP-7评分差异无统计学意义(3.4±-1.3vs2.5±-1.3vs2.5+/-1.6，p=0.12)，心动过缓(4 1 2vs2.9+/-1.4，p=0.45)，低氧血症(3.4+/-1.5vs2.4+/-1.3vs2.4+/-1.3，p=0.051)。根据我们的数据，前列腺癌在儿童中并不少见。根据SUDEP-7量表的衡量，患有pGES的儿童患SUDEP的风险可能更大。(C)2013爱思唯尔B.V.保留所有权利。
Although the pathophysiologic mechanism of sudden unexpected death in epilepsy (SUDEP) is unknown, autonomic dysfunction is thought to be the most likely. It has been hypothesized that respiratory depression resulting in SUDEP may be secondary to postictal generalized electroencephalography suppression (PGES). We sought to determine the characteristics of PGES in children. This included whether PGES was associated with ictally mediated autonomic changes and potential increased risk of SUDEP. Children admitted to our Pediatric Epilepsy Monitoring Unit between 3/2009 and 10/2011 were prospectively recruited. Clinical and electrophysiological data from children with PGES were compared to those without PGES. Data included the occurrence of peri-ictal tachycardia, bradycardia, and hypoxemia. Potential SUDEP risk was assessed using 5UDEP-7 Inventory scores. Thirty seven children with 168 seizures were analyzed. PGES was observed following 27/168 (16.1%) seizures in 12/37 (32.4%) children. Only primary and secondarily generalized tonic clonic seizures were marked by PGES. PGES was significantly associated with peri-ictal tachycardia (p=0.019) and hypoxemia (p=0.005). Children with PGES had significantly higher SUDEP-7 Inventory scores than those without PGES (4.2 +/- 1.3 versus 2.8 +/- 1.4, p=0.007). SUDEP-7 scores were not significantly different between children with and without peri-ictal tachycardia (3.4 +/- 1.3 versus 2.5 +/- 1.6, p=0.12), bradycardia (4 1 2 versus 2.9 +/- 1.4, p=0.45), or hypoxemia (3.4 +/- 1.5 versus 2.4 +/- 1.3, p=0.051). Based on our data, PGES is not rare in children. Children with PGES may be at greater risk for SUDEP as measured by the SUDEP-7 Inventory. (C) 2013 Elsevier B.V. All rights reserved.