Carrera E, Michel P, Despland P-A, Maeder-Ingvar M, Ruffieux C, Debatisse D, Ghika J, Devuyst G, Bogousslavsky J
Department of Neurology, University Hospital, Lausanne, Switzerland.
Neurology. 2006 Jul 11;67(1):99-104. doi: 10.1212/01.wnl.0000223361.90278.ca.
To determine the incidence and risk factors of electrical seizures and other electrical epileptic activity using continuous EEG (cEEG) in patients with acute stroke.
One hundred consecutive patients with acute stroke admitted to our stroke unit underwent cEEG using 10 electrodes. In addition to electrical seizures, repetitive focal sharp waves (RSHWs), repetitive focal spikes (RSPs), and periodic lateralized epileptic discharges (PLEDs) were recorded.
In the 100 patients, cEEG was recorded for a mean duration of 17 hours 34 minutes (range 1 hour 12 minutes to 37 hours 10 minutes). Epileptic activity occurred in 17 patients and consisted of RSHWs in seven, RSPs in seven, and PLEDs in three. Electrical seizures occurred in two patients. On univariate Cox regression analysis, predictors for electrical epileptic activity were stroke severity (high score on the National Institutes of Health Stroke Scale) (hazard ratio [HR] 1.12; p = 0.002), cortical involvement (HR 5.71; p = 0.021), and thrombolysis (HR 3.27; p = 0.040). Age, sex, stroke type, use of EEG-modifying medication, and cardiovascular risk factors were not predictors of electrical epileptic activity. On multivariate analysis, stroke severity was the only independent predictor (HR 1.09; p = 0.016).
In patients with acute stroke, electrical epileptic activity occurs more frequently than previously suspected.
采用连续脑电图（cEEG）确定急性卒中患者电惊厥及其他电癫痫活动的发生率和危险因素。
100例连续入住我院卒中单元的急性卒中患者使用10个电极进行cEEG检查。除电惊厥外，还记录了重复性局灶性尖波（RSHWs）、重复性局灶性棘波（RSPs）和周期性一侧性癫痫样放电（PLEDs）。
100例患者cEEG记录的平均时长为17小时34分钟（范围1小时12分钟至37小时10分钟）。17例患者出现癫痫活动，其中7例为RSHWs，7例为RSPs，3例为PLEDs。2例患者发生电惊厥。单因素Cox回归分析显示，电癫痫活动的预测因素为卒中严重程度（美国国立卫生研究院卒中量表高分）（风险比[HR]1.12；p = 0.002）、皮质受累（HR 5.71；p = 0.021）和溶栓治疗（HR 3.27；p = 0.040）。年龄、性别、卒中类型、使用脑电图调节药物和心血管危险因素不是电癫痫活动的预测因素。多因素分析显示，卒中严重程度是唯一的独立预测因素（HR 1.09；p = 0.016）。
在急性卒中患者中，电癫痫活动的发生率比之前怀疑的更高。
