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临床特征的实用性用于识别住院患者的电图发作,这些患者因非神经学诊断而入院

Carolyn Tsai¹, Courtney Blodgett¹, Sunghyun Seo¹

¹Department of Neurology, University of North Carolina (UNC) Chapel Hill, Chapel Hill, NC.

Critical care explorations

|October 21, 2024

概括

像眼睛运动和抽这样的临床症状在没有神经疾病的重症患者中检测电图发作 (ESz) 是不可靠的. 需要进一步的研究来证实这些发现.

科学领域:

关键护理医学关键护理医学
神经学神经学
临床神经生理学临床神经生理学

背景情况:

电图发作 (ESz),没有突出的运动活动的发作,是严重病患有意识改变的常见并发症.
以前的研究表明,眼部异常和面部抽等临床指标可能预测ESz.

研究的目的:

评估临床特征的有效性,以识别ESz在严重病患者经历意识变化.

主要方法:

一项回顾性病例控制研究,涉及50名成人住院患者,在联合国加州大学医学中心和联合国加州大学雷克斯医院接受连续视频脑电图 (cEEG).
根据cEEG持续时间,ESz (n=25) 的患者与对照组 (n=25) 相匹配;初级神经病诊断的患者被排除在外.
以往与ESz相关的历史和物理发现被收集并使用描述性统计数据进行分析.

主要成果:

在ESz.患者和没有ESz.患者之间,没有观察到先前识别的敏感临床发现的显著差异.
概率比率表明,这些临床症状是ESz的不准确预测指标,值一般在1-2 (阳性) 和0.5-1 (阴性) 之间.
经历ESz的患者的死亡率明显更高 (p=0.012).

结论:

在治疗在三级保健中心的非神经学原发性诊断的重症患者中,常见的临床症状对ESz的预测准确性较低.
这些发现不能将其推广到神经病症患者或不同CEEEG可访问性的环境中.
在这项探索性分析中,临床症状不能可靠地对ESz对cEEG的风险进行分层,因此需要进一步的前性研究.

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