van Donselaar C A, Schimsheimer R J, Geerts A T, Declerck A C
Department of Neurology and Clinical Neurophysiology, University Hospital Rotterdam-Dijkzigt, The Netherlands.
Arch Neurol. 1992 Mar;49(3):231-7. doi: 10.1001/archneur.1992.00530270045017.
We prospectively studied the reliability and accuracy of the electroencephalogram as a predictor of the risk of recurrence within 2 years in 157 patients with untreated idiopathic first seizures. In all patients, a standard electroencephalogram and, if necessary, an electroencephalogram after partial sleep deprivation were obtained. All electroencephalograms were scored by one observer according to a fixed protocol. The finding of epileptic discharges was associated with a risk of recurrence of 83% (95% confidence interval, 69% to 97%) vs 41% (95% confidence interval, 29% to 53%) in patients with nonepileptic abnormalities and 12% (95% confidence interval, 3% to 21%) in patients in whom both electroencephalograms were normal. The sensitivity proved to be 48%. Interobserver agreement among four neurologists, who independently read 50 electroencephalograms, was found to be moderate. Predictive value for each observer, however, was good. We conclude that electroencephalogram findings may play a role in the decision to initiate or delay treatment after an idiopathic first seizure.
我们前瞻性地研究了脑电图作为157例未经治疗的特发性首次发作患者2年内复发风险预测指标的可靠性和准确性。对所有患者均进行了标准脑电图检查，必要时还进行了部分睡眠剥夺后的脑电图检查。所有脑电图均由一名观察者按照固定方案进行评分。发现癫痫样放电的患者复发风险为83%（95%置信区间，69%至97%），而非癫痫样异常患者为41%（95%置信区间，29%至53%），脑电图均正常的患者为12%（95%置信区间，3%至21%）。敏感性为48%。4名神经科医生独立阅读50份脑电图，观察者间一致性为中等。然而，每位观察者的预测价值良好。我们得出结论，脑电图检查结果可能在特发性首次发作后启动或延迟治疗的决策中发挥作用。
