Departments of Neurology, National Institute of Mental Health and NeuroSciences (NIMHANS), Bangalore, India.
J Clin Neurophysiol. 2011 Aug;28(4):388-93. doi: 10.1097/WNP.0b013e318227775c.
The authors evaluated the spectra of EEG observations in elderly patients with new onset seizures and correlated it with clinical, laboratory, and imaging findings.
This prospective study involved 201 elderly individuals (age: 68.0 ± 7.5 years; male:female = 1.8:1) who manifested with new onset seizures. Data regarding clinical, laboratory, routine EEG (n = 201), and imaging (computerized tomography = 201; MRI = 43) observations were noted. Details of EEG findings were analyzed and correlated with other parameters.
Visual analysis of scalp EEG in 124 patients (61.7%) was abnormal, and the abnormalities included asymmetric background activity (3%) and diffuse slowing (32.8%) and focal slowing (7%) of the background activity. Dominant α-activity was more common in remote symptomatic group. Higher frequency of alpha waves was observed in patients with cryptogenic epilepsy compared with those with acute symptomatic epilepsy. Diffuse slowing and excess of β-fast activity were observed more often in acute symptomatic group. Epileptiform activities were evident in one third of patients and were noted in the temporal (38.8%) and frontotemporal (23.9%) regions. In univariate analysis of patients with and without EEG abnormalities, female gender, cluster attacks/status epilepticus, acute symptomatic epilepsy, longer duration of postictal state, lower Glasgow coma scale score, lower Mini-Mental State Examination score, focal deficits, diffuse edema (computerized tomography), and focal lesions (MRI) were significantly associated with abnormal EEG. Presence of epileptiform activity predicted the use of polytherapy (P = 0.004, odds ratio = 3.3). The significant factors associated with an abnormal EEG (multivariate) were female gender (P = 0.03, odds ratio = 2.32), lower Glasgow coma scale score (P = 0.03, odds ratio = 0.70), and lower frequency of α-waves (P = 0.04, odds ratio = 0.56).
Scalp EEG was abnormal in approximately two thirds of elderly patients, with the presence of epileptiform activities in one third of patients. Abnormal EEG significantly correlated with lower Glasgow coma scale score, suggesting its role in prognostication.
作者评估了新发癫痫老年患者的 EEG 观察结果，并将其与临床、实验室和影像学发现相关联。
这是一项前瞻性研究，共纳入 201 名新发癫痫的老年患者（年龄：68.0±7.5 岁；男女比例为 1.8:1）。记录患者的临床、实验室、常规 EEG（n=201）和影像学（计算机断层扫描=201；磁共振成像=43）数据。分析 EEG 结果的详细信息，并与其他参数相关联。
124 名患者（61.7%）的头皮 EEG 视觉分析异常，异常表现包括背景活动不对称（3%）、背景活动弥漫性减慢（32.8%）和局灶性减慢（7%）。在远隔症状性组中更常见到主导α-活动。与急性症状性癫痫相比，隐源性癫痫患者的α 波频率更高。弥漫性减慢和β-快活动增加在急性症状性组中更常见。三分之一的患者出现癫痫样活动，颞叶（38.8%）和额颞叶（23.9%）区域可见。在 EEG 正常与异常患者的单因素分析中，女性、簇状发作/癫痫持续状态、急性症状性癫痫、发作后状态持续时间较长、格拉斯哥昏迷量表评分较低、简易精神状态检查评分较低、局灶性缺损、弥漫性水肿（计算机断层扫描）和局灶性病变（磁共振成像）与 EEG 异常显著相关。癫痫样活动的存在预测了多药治疗的使用（P=0.004，优势比=3.3）。与异常 EEG 相关的显著因素（多变量）为女性（P=0.03，优势比=2.32）、格拉斯哥昏迷量表评分较低（P=0.03，优势比=0.70）和α-波频率较低（P=0.04，优势比=0.56）。
大约三分之二的老年患者的头皮 EEG 异常，三分之一的患者存在癫痫样活动。异常 EEG 与格拉斯哥昏迷量表评分较低显著相关，表明其在预后评估中的作用。
