Lawrence Russell, Mathur Amit, Nguyen The Tich Sylvie, Zempel John, Inder Terrie
Department of Pediatrics, St Louis Children's Hospital, Washington University, St Louis, MO 63110, USA.
J Pediatr. 2009 Jun;154(6):835-41.e1. doi: 10.1016/j.jpeds.2009.01.002. Epub 2009 Feb 23.
To evaluate the accuracy, feasibility, and impact of limited-channel amplitude integrated electroencephalogram (aEEG) monitoring in encephalopathic infants.
Encephalopathic infants were placed on limited-channel aEEG with a software-based seizure event detector for 72 hours. A 12-hour epoch of conventional EEG-video (cEEG) was simultaneously collected. Infants were randomly assigned to monitoring that was blinded or visible to the clinical team. If a seizure detection event occurred in the visible group, the clinical team interpreted whether the event was a seizure, based on review of the limited-channel aEEG. EEG data were reviewed independently offline.
In more than 68 hours per infant of limited-channel aEEG monitoring, 1116 seizures occurred (>90% clinically silent), with 615 detected by the seizure event detector (55%). Detection improved with increasing duration of seizures (73% >30 seconds, 87% >60 seconds). Bedside physicians were able to accurately use this algorithm to differentiate true seizures from false-positives. The visible group had a 52% reduction in seizure burden (P = .114) compared with the blinded group.
Monitoring for seizures with limited-channel aEEG can be accurately interpreted, compares favorably with cEEG, and is associated with a trend toward reduced seizure burden.
评估有限通道振幅整合脑电图（aEEG）监测在脑病婴儿中的准确性、可行性及影响。
将脑病婴儿置于有限通道aEEG监测下，使用基于软件的癫痫发作事件检测器进行72小时监测。同时收集12小时的常规脑电图-视频（cEEG）。婴儿被随机分配至临床团队不知情或知情的监测组。若在知情组发生癫痫检测事件，临床团队根据有限通道aEEG回顾结果来判断该事件是否为癫痫发作。脑电图数据在离线状态下独立回顾。
在每位婴儿超过68小时的有限通道aEEG监测中，共发生1116次癫痫发作（>90%在临床上无症状），癫痫发作事件检测器检测到615次（55%）。随着癫痫发作持续时间增加，检测率提高（>30秒的为73%，>60秒的为87%）。床边医生能够准确使用该算法区分真正的癫痫发作与假阳性。与不知情组相比，知情组的癫痫发作负荷降低了52%（P = 0.114）。
有限通道aEEG癫痫发作监测能够得到准确解读，与cEEG相比具有优势，且与癫痫发作负荷降低的趋势相关。
