Sheth R D
Department of Neurology, University of Wisconsin, Madison 53792-5132, USA.
Pediatr Neurol. 1999 Jan;20(1):27-30. doi: 10.1016/s0887-8994(98)00078-2.
The electroencephalogram (EEG) is confirmatory in 70% of children and adults with seizures, although gestation- and etiology-specific EEG confirmatory rates in neonates have not been well defined. All neonates treated for seizures and who underwent EEG were identified from 4,575 neonates admitted between 1985 and 1996 to a neonatal intensive care unit. The relationship between EEG findings (epileptiform discharges and background abnormalities) and gestation, mortality rate, and seizure etiology was examined using the Student t test. One hundred eighty-three neonates treated for seizures underwent a total of 352 EEGs: 144 of these neonates (79%) had an abnormal EEG (epileptiform discharges in 113 (60%) and nonepileptiform background abnormalities in 31). The EEG confirmatory rate increased with gestation (63% at 28 weeks vs 77% at term, P < 0.02). Etiology for seizures also influenced the EEG confirmatory rate: central nervous system (CNS) infection 95% (P < 0.05), hypoxic-ischemic encephalopathy 80% (P < 0.05), germinal matrix-intraventricular hemorrhage 65%, and CNS malformations 65%. The EEG confirmatory rate was predictive of neonatal mortality (19% vs 6%, P < 0.03). The EEG was directly confirmatory (epileptiform discharges) in 60% and supportive (nonepileptiform background abnormalities) in a further 17% of neonates with seizures. Gestation and etiology influence the EEG confirmatory rate in neonatal seizures.
脑电图（EEG）在70%的儿童和成人癫痫患者中具有确诊价值，不过新生儿中按妊娠情况和病因分类的EEG确诊率尚未明确界定。从1985年至1996年间收治到新生儿重症监护病房的4575例新生儿中，确定了所有接受癫痫治疗并进行了EEG检查的新生儿。使用学生t检验研究了EEG结果（癫痫样放电和背景异常）与妊娠、死亡率及癫痫病因之间的关系。183例接受癫痫治疗的新生儿共进行了352次EEG检查：其中144例（79%）EEG异常（113例（60%）有癫痫样放电，31例有非癫痫样背景异常）。EEG确诊率随孕周增加而升高（28周时为63%，足月时为77%，P<0.02）。癫痫病因也影响EEG确诊率：中枢神经系统（CNS）感染为95%（P<0.05），缺氧缺血性脑病为80%（P<0.05），生发基质-脑室内出血为65%，CNS畸形为65%。EEG确诊率可预测新生儿死亡率（19%对6%，P<0.03）。在癫痫新生儿中，60%的EEG可直接确诊（癫痫样放电），另有17%具有支持性（非癫痫样背景异常）。妊娠情况和病因会影响新生儿癫痫的EEG确诊率。
