Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria.
Clin Neurophysiol. 2012 Mar;123(3):459-62. doi: 10.1016/j.clinph.2011.06.025. Epub 2011 Jul 19.
Diagnosis of NCSE is challenging, because the clinical presentation ranges from minimally altered mental status to coma without tonic-clonic activity. According to the largest retrospective study to date the incidence of NCSE is about 0.2%.
We prospectively investigated electroencephalography (EEG) recordings of 2514 consecutive patients that were referred to the Electrophysiology Unit of Department of Neurology, Vienna General Hospital between November 2009 and February 2011 (i.e. 16months).
The incidence of NCSE in our study population was 0.8%, i.e. the EEG of 19 patients fulfilled the criteria of NCSE. In 53% of these patients the NCSE was not suspected by treating physicians. A severely reduced level of consciousness was found in 78% of patients with a suspected NCSE and in 30% of patients with an unsuspected NCSE, although the results were not statistically significant (p=0.081). The delay between the admission to the hospital and diagnosis ranged between 0 and 51days.
NCSE was an unsuspected finding in more than half of the patients. Consciousness was severely impaired in only one third of these patients.
These results highlight the importance of urgent EEG for the diagnosis of NCSE in patients even without significant impairment of consciousness.
NCSE 的诊断具有挑战性，因为其临床表现从轻度意识改变到无强直-阵挛活动的昏迷不等。根据迄今为止最大的回顾性研究，NCSE 的发病率约为 0.2%。
我们前瞻性地调查了 2009 年 11 月至 2011 年 2 月期间维也纳总医院神经科电生理科收治的 2514 例连续患者的脑电图（EEG）记录（即 16 个月）。
在我们的研究人群中，NCSE 的发病率为 0.8%，即 19 名患者的 EEG 符合 NCSE 的标准。在这些患者中，有 53%的患者未被治疗医生怀疑有 NCSE。怀疑有 NCSE 的患者中 78%存在严重的意识水平降低，而未怀疑有 NCSE 的患者中则有 30%存在这种情况，尽管结果无统计学意义（p=0.081）。从入院到诊断的时间间隔为 0 至 51 天。
超过一半的患者的 NCSE 是未被怀疑的。这些患者中只有三分之一的意识严重受损。
这些结果强调了即使患者的意识没有明显受损，也需要紧急进行 EEG 以诊断 NCSE。
