电图发作特征和电图状态 预测
France W Fung1,2, Darshana S Parikh1, Maureen Donnelly3
1Department of Pediatrics (Division of Neurology), Children's Hospital of Philadelphia, Philadelphia, U.S.A.
概括
电图状态 (ESE) 在重症儿童中很常见,通常呈现为反复的短暂发作. 预测ESE可能不会显著改善持续EEG监测 (CEEG) 的使用情况,并且可能会错过一些案例.
科学领域:
- 儿科神经学 儿科神经学
- 神经临界护理是指神经临界护理.
- 发病学 (Epileptology) 是一个专业的学科.
背景情况:
- 患有脑病症的重症儿童经常接受持续的EEG监测 (CEEG),以检测非性发作.
- 电图 (ES) 和电图状态 (ESE) 是关键的发现,但它们的特征和最佳预测策略需要进一步阐明.
研究的目的:
- 在重症儿童中表征电图发作 (ES) 和电图状态 (ESE).
- 评估ESE的预测模型,以指导持续EEG监测 (CEEG) 的使用.
主要方法:
- 对1399名患有重症脑病的重症儿童进行前性观察研究,接受CEEG治疗.
- 描述性统计数据用于描述ES和ESE.
- 开发和评估一种用于ESE预测的模型.
主要成果:
- ES发生在25%的受试者身上;其中23%的人患有ESE.
- 最常见的ESE呈现为反复的短暂发作 (63%),而不是长时间的单个发作 (37%).
- 一个ESE预测模型显示AUC为0.81,但在91%的灵敏度下,特异性为56%,以6%的ESE发病率导致11%的PPV和99%的NPV.
结论:
- ESE在重症儿童中很常见,通常表现为反复出现的短暂发作.
- 专用ESE预测模型可能在CEEG利用上提供有限的改进,并可能错过ESE病例.
- 识别任何ES的风险的模型可能更有利于防止ESE的进展.
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