临床实践中的孤立性癫痫发作。第二部分：经历孤立性特发性癫痫发作患者的脑电图检查及影像学方法不同改良的结果

Solitary epileptic seizures in the clinical practice. Part II: findings of various modifications of EEG examination and imaging methods in patients who experienced solitary unprovoked epileptic seizure.

作者信息

Kollar Branislav, Martiniskova Zuzana, Klobucnikova Katarína, Vachalova Ivana, Waczulikova Iveta

机构信息

1st Department of Neurology, University Hospital, Faculty of Medicine, Comenius University, Bratislava, Slovakia.

出版信息

Neuro Endocrinol Lett. 2009;30(4):487-90.

PMID:20010487

Abstract

BACKGROUND

The occurrence of the first unprovoked epileptic seizure always requires thorough examination. The risk of incorrect diagnosis is high, non-epileptic seizures represent 20-33% of newly diagnosed cases. The aim of the study is to evaluate findings of various modifications of EEG examination in the group of patients who experienced solitary unprovoked epileptic seizure and compare benefits of CT and MRI examination of the brain of these patients.

MATERIAL AND METHODS

The group involved 84 patients hospitalized at the 1st Department of Neurology , Faculty of Medicine, Comenius University in Bratislava between January 1997 and January 2007 after experiencing unprovoked epileptic seizure. It is a retrospective analysis of information from medical records and clinical documentation. For statistic comparing of benefits of various modifications of EEG examination and between CT and MRI examination of the brain binomic test of proportion was used.

RESULTS

Interictal epileptiform EEG graphoelements in native EEG was recorded only in 14.29% of patients. Statistically significantly more epileptiform graphoelements comparing EEG and EEG after sleep deprivation of the patient (SD) with one- hour recording was recorded with 24-hour 8 channels EEG monitoring after SD, EEG after SD with one- hour recording was of no significance comparing to native EEG. MRI examination of the brain was statistically more significant comparing to CT examination.

CONCLUSION

Low catchment of epileptiform EEG graphoelements in patients with solitary unprovoked seizure shows the importance of precise history in diagnostics of these patients. Though EEG is a very important examination it is an auxiliary one. We confirmed that MRI examination in patients who experienced solitary unprovoked epileptic seizure is undoubtedly the first choice method.

摘要

背景

首次无诱因癫痫发作的发生总是需要进行全面检查。误诊风险很高，非癫痫性发作占新诊断病例的20% - 33%。本研究的目的是评估在经历单次无诱因癫痫发作的患者组中脑电图检查各种改良方法的结果，并比较这些患者脑部CT和MRI检查的益处。

材料与方法

该组包括1997年1月至2007年1月在布拉迪斯拉发夸美纽斯大学医学院第一神经内科住院的84例经历无诱因癫痫发作的患者。这是对病历和临床文档信息的回顾性分析。为了对脑电图检查各种改良方法的益处以及脑部CT和MRI检查之间进行统计学比较，使用了比例的二项式检验。

结果

仅14.29%的患者在常规脑电图中记录到发作间期癫痫样脑电图图形元素。与常规脑电图相比，对患者进行睡眠剥夺（SD）后1小时记录的脑电图与SD后24小时8通道脑电图监测相比，癫痫样图形元素在统计学上显著更多，SD后1小时记录的脑电图与常规脑电图相比无显著差异。脑部MRI检查与CT检查相比在统计学上更具显著性。