背景:没有用于检测患者癫痫样异常的标准化EEG持续时间指南,关于这个主题的研究很少。这项研究旨在确定最佳的EEG持续时间,以有效检测不同患者组的癫痫样异常。
方法:对首次发作和癫痫患者的脑电图记录和临床资料进行回顾性分析。根据各种因素对患者进行分类,包括自上次癫痫发作以来的间隔时间,使用抗癫痫药物(ASM),和癫痫发作频率。计算癫痫样异常的检出率(DR)和发现它们的潜伏期时间。统计分析,包括卡方检验,逻辑回归,和生存分析用于说明DR和潜伏期。
结果:在整晚的脑电图记录中,首次发作组的DR为37.6%,癫痫组为57.4%.虽然两组的最大潜伏期均为720分钟,第一癫痫发作组的DR明显下降超过300分钟。影响DR的重要因素包括首次癫痫发作组使用ASM(P<0.05)和癫痫发作频率(P<0.001)。对于每月至少发作一次或进行及时脑电图记录(发作后24小时内)的癫痫患者,DR显著增加,最大潜伏期缩短至600min(P<0.001)。此外,无癫痫发作超过1年的癫痫患者在240分钟后DR显著降低.
结论:在这项回顾性研究中,我们观察到在整晚脑电图记录中检测癫痫样异常的最大潜伏期为720分钟.值得注意的是,癫痫发作频率较高或及时进行EEG记录的癫痫患者表现出较高的检测率和较短的最大潜伏期。对于检出率低的患者,例如第一次癫痫发作的患者或一年以上无癫痫发作的癫痫患者,建议较短的脑电图持续时间。这些发现强调了实施定制的EEG策略以满足不同患者群体的特定需求的重要性。
BACKGROUND: There is no standardized EEG duration guideline for detecting epileptiform abnormalities in patients, and research on this topic is scarce. This study aims to determine an optimal EEG duration for efficient detection of epileptiform abnormalities across different patient groups.
METHODS: Retrospective analysis was performed on EEG recordings and clinical data of patients with the first seizure and epilepsy. Patients were categorized based on various factors, including the interval time since the last seizure, use of anti-seizure medication (ASM), and seizure frequency. The detection ratio (DR) of epileptiform abnormalities and latency time for their discovery were calculated. Statistical analyses, including chi-square tests, logistic regression, and survival analysis were utilized to illustrate DR and latency times.
RESULTS: In whole-night EEG recordings, the DR was 37.6% for the first seizure group and 57.4% for the epilepsy group. Although the maximum latency times were 720 min in both two groups, DR in the first seizure group was distinctly decreased beyond 300 min. Significant factors influencing the DR included the use of ASM in the first seizure group (P < 0.05) and seizure frequency in the epilepsy group (P < 0.001). For epilepsy patients who experience a seizure at least once a month or undergo timely EEG recordings (within 24 h after a seizure), the DR significantly increases, and the maximum latency time is reduced to 600 min (P < 0.001). Additionally, the DR was significantly reduced after 240 min in epilepsy patients who had been seizure-free for more than one year.
CONCLUSIONS: In this retrospective study, we observed a maximum latency of 720 min for detecting epileptiform abnormalities in whole-night EEG recordings. Notably, epilepsy patients with a higher seizure frequency or timely EEG recordings demonstrated both a higher detection ratio and a shorter maximum latency time. For patients exhibiting a low detection ratio, such as those experiencing their first seizure or those with epilepsy who have been seizure-free for more than a year, a shorter EEG duration is recommended. These findings underscore the importance of implementing customized EEG strategies to meet the specific needs of different patient groups.