PDF(Pubmed)
Abstract：
UNASSIGNED: The aim herein was to investigate epileptiform discharges on electroencephalogram (EEG), their correlation with glutamic acid decarboxylase 65 autoantibody (GAD-ab) in newly diagnosed pediatric type 1 diabetes mellitus (T1DM) patients and interpret their medium-term utility in predicting epilepsy.
UNASSIGNED: Children presenting with T1DM between July 2018 and December 2019 were included in this prospective longitudinal study. Patients with a history of head injury, chronic illness, neurological disorder, seizure, autism, or encephalopathy were excluded. EEGs were obtained within the first 7 days of diagnosis and later reviewed by a pediatric neurologist. All of the children were clinically followed-up in pediatric endocrinology and neurology clinics for 2 years after their diagnosis.
UNASSIGNED: A total of 105 children (46 male, 43.8%) were included. The mean age at the time of diagnosis was 9.6 ± 4.1 years (range: 11 months-17.5 years). At the time of admission, 24 (22.9%), 29 (27.6%), and 52 (49.5%) patients had hyperglycemia, ketosis, and diabetic ketoacidosis, respectively. GAD-ab was positive in 55 children (52.4%). No background or sleep architecture abnormalities or focal slowing were present on the EEGs. Of the patients, 3 (2.9%) had focal epileptiform discharges. The mean GAD-ab levels of the remaining 102 patients were 7.48 ± 11.97 U/mL (range: 0.01-50.54) (p = 0.2). All 3 children with EEG abnormality had higher levels of GAD-ab (3.59 U/mL, 31.3 U/mL, and 7.09 U/mL, respectively). None of the patients developed epilepsy during the follow-up, although 1 patient experienced Guillain-Barré syndrome (GBS).
UNASSIGNED: The prevalence of epileptiform discharges in the patients was similar to those of previous studies, in which healthy children were also included. No relationship was found between the epileptiform discharges and GAD-ab, and none of the patients manifested seizures during the first 2 years of follow-up of T1DM. These data support the findings of previous studies reporting that T1DM patients with confirmed electroencephalographic abnormalities do not have an increased risk of epilepsy. On the other hand, GBS might be considered as another autoimmune disease that may be associated with T1DM in children.
UNASSIGNED: Children presenting with T1DM between July 2018 and December 2019 were included in this prospective longitudinal study. Patients with a history of head injury, chronic illness, neurological disorder, seizure, autism, or encephalopathy were excluded. EEGs were obtained within the first 7 days of diagnosis and later reviewed by a pediatric neurologist. All of the children were clinically followed-up in pediatric endocrinology and neurology clinics for 2 years after their diagnosis.
UNASSIGNED: A total of 105 children (46 male, 43.8%) were included. The mean age at the time of diagnosis was 9.6 ± 4.1 years (range: 11 months-17.5 years). At the time of admission, 24 (22.9%), 29 (27.6%), and 52 (49.5%) patients had hyperglycemia, ketosis, and diabetic ketoacidosis, respectively. GAD-ab was positive in 55 children (52.4%). No background or sleep architecture abnormalities or focal slowing were present on the EEGs. Of the patients, 3 (2.9%) had focal epileptiform discharges. The mean GAD-ab levels of the remaining 102 patients were 7.48 ± 11.97 U/mL (range: 0.01-50.54) (p = 0.2). All 3 children with EEG abnormality had higher levels of GAD-ab (3.59 U/mL, 31.3 U/mL, and 7.09 U/mL, respectively). None of the patients developed epilepsy during the follow-up, although 1 patient experienced Guillain-Barré syndrome (GBS).
UNASSIGNED: The prevalence of epileptiform discharges in the patients was similar to those of previous studies, in which healthy children were also included. No relationship was found between the epileptiform discharges and GAD-ab, and none of the patients manifested seizures during the first 2 years of follow-up of T1DM. These data support the findings of previous studies reporting that T1DM patients with confirmed electroencephalographic abnormalities do not have an increased risk of epilepsy. On the other hand, GBS might be considered as another autoimmune disease that may be associated with T1DM in children.
摘要：
■本文的目的是研究脑电图（EEG）上的癫痫样放电，在新诊断的儿童1型糖尿病（T1DM）患者中，它们与谷氨酸脱羧酶65自身抗体（GAD-ab）的相关性，并解释其在预测癫痫中的中期效用。
■在2018年7月至2019年12月期间出现T1DM的儿童被纳入这项前瞻性纵向研究。有头部损伤史的患者,慢性病,神经紊乱,癫痫发作,自闭症,或脑病被排除。脑电图是在诊断的前7天内获得的，随后由儿科神经科医生进行审查。诊断后，所有儿童均在儿科内分泌科和神经科诊所进行了2年的临床随访。
■共有105名儿童（46名男性，43.8%）包括在内。诊断时的平均年龄为9.6±4.1岁（范围：11个月-17.5岁）。在录取的时候,24（22.9%），29（27.6%），52例（49.5%）患者有高血糖，酮症,和糖尿病酮症酸中毒，分别。55名儿童GAD-ab阳性(52.4%)。脑电图上没有背景或睡眠结构异常或局灶性减慢。在患者中，3例(2.9%)有局灶性癫痫样放电。其余102例患者的平均GAD-ab水平为7.48±11.97U/mL（范围：0.01-50.54）（p=0.2）。所有3例脑电图异常患儿的GAD-ab水平均较高(3.59U/mL,31.3U/mL,和7.09U/mL，分别)。在随访期间没有患者出现癫痫,尽管1例患者出现格林-巴利综合征（GBS）。
■患者癫痫样放电的患病率与以前的研究相似，健康儿童也包括在内。未发现癫痫样放电与GAD-ab之间的关系，在T1DM随访的前2年中，没有患者出现癫痫发作。这些数据支持以前的研究发现，证实脑电图异常的T1DM患者没有增加癫痫的风险。另一方面,GBS可能被认为是另一种与儿童T1DM相关的自身免疫性疾病。
■在2018年7月至2019年12月期间出现T1DM的儿童被纳入这项前瞻性纵向研究。有头部损伤史的患者,慢性病,神经紊乱,癫痫发作,自闭症,或脑病被排除。脑电图是在诊断的前7天内获得的，随后由儿科神经科医生进行审查。诊断后，所有儿童均在儿科内分泌科和神经科诊所进行了2年的临床随访。
■共有105名儿童（46名男性，43.8%）包括在内。诊断时的平均年龄为9.6±4.1岁（范围：11个月-17.5岁）。在录取的时候,24（22.9%），29（27.6%），52例（49.5%）患者有高血糖，酮症,和糖尿病酮症酸中毒，分别。55名儿童GAD-ab阳性(52.4%)。脑电图上没有背景或睡眠结构异常或局灶性减慢。在患者中，3例(2.9%)有局灶性癫痫样放电。其余102例患者的平均GAD-ab水平为7.48±11.97U/mL（范围：0.01-50.54）（p=0.2）。所有3例脑电图异常患儿的GAD-ab水平均较高(3.59U/mL,31.3U/mL,和7.09U/mL，分别)。在随访期间没有患者出现癫痫,尽管1例患者出现格林-巴利综合征（GBS）。
■患者癫痫样放电的患病率与以前的研究相似，健康儿童也包括在内。未发现癫痫样放电与GAD-ab之间的关系，在T1DM随访的前2年中，没有患者出现癫痫发作。这些数据支持以前的研究发现，证实脑电图异常的T1DM患者没有增加癫痫的风险。另一方面,GBS可能被认为是另一种与儿童T1DM相关的自身免疫性疾病。
