Legido Agustín, Valencia Ignacio
Sección de Neurología, Departamento de Pediatría, St. Christopher's Hospital for Children, Drexel University College of Medicine, Philadelphia PA 19134, USA.
Medicina (B Aires). 2009;69(1 Pt 1):92-100.
The diagnosis of epilepsy is basically clinical, but it frequently raises the differential diagnosis with non-epileptic events. The development of continuous EEG monitoring (CEEGM) in the past decades has allowed a better diagnosis of epileptic patients of all ages. In this paper we review the data available in the literature about the efficacy of the different modalities of CEEGM in the diagnosis of pediatric epilepsy, emphasizing our personal experience. In our studies the ambulatory CEEGM supplemented with video allowed to answer the question that prompted its request in 80% of patients diagnosed with epilepsy and in 83% of those with the suspected diagnosis of epilepsy. With ambulatory computer-assisted CEEGM those figures were 88% and 89%, respectively, and with inpatient video-CEEGM they were 82% and 51%, respectively. The latter is crucial in the evaluation of epilepsy patients who are candidates for surgical treatment. Inpatient video-CEEGM is also very important in the management of patients with acute encephalopathies admitted to the Intensive Care Units. Both, ambulatory or inpatient CEEGM, are very useful in the differential diagnosis of clinical epileptic versus non-epileptic events, as well as in the confirmation of the type of epilepsy or epileptic syndrome. The development of technological advances and new EEG modalities in the future will help to continue to consider electroencephalography as a very important technique in the study of brain function in patients with acute or chronic encephalopathies.
癫痫的诊断基本依靠临床,但它常常会引发与非癫痫性事件的鉴别诊断。在过去几十年中,动态脑电图监测(CEEGM)的发展使得各年龄段癫痫患者都能得到更好的诊断。在本文中,我们回顾了文献中有关不同模式的CEEGM在小儿癫痫诊断中的有效性的数据,并着重介绍我们的个人经验。在我们的研究中,配备视频的动态CEEGM能够解答促使其检查的问题,在确诊癫痫的患者中占80%,在疑似癫痫的患者中占83%。对于动态计算机辅助CEEGM,这两个数字分别为88%和89%,而住院患者视频CEEGM的相应数字分别为82%和51%。后者对于评估适合手术治疗的癫痫患者至关重要。住院患者视频CEEGM在重症监护病房收治的急性脑病患者的管理中也非常重要。动态或住院CEEGM在临床癫痫与非癫痫性事件的鉴别诊断以及癫痫类型或癫痫综合征的确认中都非常有用。未来技术进步和新的脑电图模式的发展将有助于继续把脑电图视为研究急性或慢性脑病患者脑功能的一项非常重要的技术。