Tekgul Hasan, Bourgeois Blaise F D, Gauvreau Kimberlee, Bergin Ann M
Department of Neurology, Division of Epilepsy and Clinical Neurophysiology, Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA.
Pediatr Neurol. 2005 Mar;32(3):155-61. doi: 10.1016/j.pediatrneurol.2004.09.014.
This study compares a reduced electrode montage (9 electrodes) with the full 10/20 electrode montage for the ability to detect and characterize neonatal seizures and background electroencephalographic (EEG) characteristics, utilizing new digital technology allowing "remontage" of previously acquired records. A total of 151 neonatal EEG records were retrospectively and blindly analyzed by two readers. Records were first analyzed for seizure number, topography, duration, and characteristics of EEG background using the reduced montage, before reanalysis with the full montage. One hundred eighty-seven seizures were identified in 31 ictal recordings using the full montage. Using the reduced montage, 166 seizures were identified in 30 records. The sensitivity and specificity of the reduced montage for detecting electrographic seizures was 96.8% and 100% respectively. In only one patient's record, the single seizure was missed altogether. For grading background abnormalities, the sensitivity and specificity of reduced montage was 87% and 80%. Although there are inherent weaknesses in reduced montages with respect to both underestimation and overestimation of seizure number, a nine-electrode reduced montage can be a sensitive tool for identification of neonatal seizures and assessment of background characteristics of neonatal electroencephalography.
本研究利用可对先前采集记录进行“重新组合”的新数字技术，比较了简化电极组合（9个电极）与完整的10/20电极组合在检测和描述新生儿癫痫发作及背景脑电图（EEG）特征方面的能力。两位读者对151份新生儿EEG记录进行了回顾性盲法分析。首先使用简化组合分析记录的癫痫发作次数、部位、持续时间以及EEG背景特征，然后再用完整组合进行重新分析。使用完整组合在31份发作期记录中识别出187次癫痫发作。使用简化组合在30份记录中识别出166次癫痫发作。简化组合检测脑电图癫痫发作的敏感性和特异性分别为96.8%和100%。仅在一份患者记录中，单次癫痫发作被完全漏诊。对于背景异常分级，简化组合的敏感性和特异性分别为87%和80%。尽管简化组合在癫痫发作次数的低估和高估方面存在固有缺陷，但九电极简化组合可作为识别新生儿癫痫发作和评估新生儿脑电图背景特征的敏感工具。
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