Alehan F K, Morton L D, Pellock J M
Division of Child Neurology, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298-0211, USA.
J Child Neurol. 2001 Jul;16(7):484-7. doi: 10.1177/088307380101600704.
To assess the role of electroencephalography (EEG) in the pediatric emergency department, we reviewed the records of all patients having an EEG in the pediatric emergency department of our hospital between 1995 and 1997. EEG findings, clinical presentations, and follow-up data were analyzed, and patients were distributed into three groups according to clinical presentation: group 1 included patients with new-onset seizures, group 2 included patients with known epilepsy presenting with worsening seizures and altered mentation, and group 3 comprised patients with acute confusional states. Overall, 56 patients with 57 EEGs were included. In group 1 (n = 36), 20 (55.6%) had an abnormal EEG. The risk of recurrence was much higher in children with abnormal EEGs (80% vs. 31%) (P < .01). In retrospect, among all of the patients receiving the diagnosis of epilepsy, 76% had an abnormal emergency department EEG. Four in group 2 (n = 14) and one in group 3 (n = 7) were proven to have nonconvulsive status epilepticus and were treated accordingly. No patients in group 1 had nonconvulsive status epilepticus. Ongoing seizures were promptly excluded in the remainder. The EEG directly contributed to the diagnosis in 84% of all referrals in the pediatric emergency department, either being abnormal and leading to a diagnosis of a seizure disorder or confirming low suspicion for seizures. Thus, a prompt EEG should be considered in children with new-onset seizures and unexplained altered consciousness.
为评估脑电图（EEG）在儿科急诊科的作用，我们回顾了1995年至1997年我院儿科急诊科所有接受脑电图检查的患者记录。分析了脑电图结果、临床表现和随访数据，并根据临床表现将患者分为三组：第1组包括新发癫痫患者，第2组包括已知癫痫且癫痫发作加重和意识改变的患者，第3组包括急性意识模糊状态的患者。总体而言，纳入了56例患者的57次脑电图检查。在第1组（n = 36）中，20例（55.6%）脑电图异常。脑电图异常的儿童复发风险要高得多（80%对31%）（P <.01）。回顾发现，在所有被诊断为癫痫的患者中，76%的患者急诊科脑电图异常。第2组（n = 14）中有4例，第3组（n = 7）中有1例被证实患有非惊厥性癫痫持续状态并接受了相应治疗。第1组中没有患者患有非惊厥性癫痫持续状态。其余患者中正在发作的癫痫被迅速排除。脑电图直接有助于儿科急诊科所有转诊患者中84%的诊断，要么脑电图异常并导致癫痫发作障碍的诊断，要么证实对癫痫发作的怀疑较低。因此，对于新发癫痫和不明原因意识改变的儿童，应考虑及时进行脑电图检查。
