Department of Physiotherapy, State University of Paraiba.
J Clin Neurophysiol. 2012 Feb;29(1):55-7. doi: 10.1097/WNP.0b013e318246b589.
EEG is a popular, low-cost examination used in neurologic and nonneurologic evaluations. Nevertheless, the diagnostic usefulness of EEG has some limitations, and it may increase medical costs. The manifestations of syncope may lead to misdiagnoses, and frequently, it is mislabeled as epilepsy. An EEG is usually obtained, yet some studies have suggested that EEGs have little value in diagnosing this condition. We aimed to determine the diagnostic usefulness of EEG in patients with syncope. We retrospectively examined EEG recordings of 10,408 patients. EEG findings were evaluated for all patients with a diagnosis of syncope (syncope, convulsive syncope, loss of consciousness, or sudden unexplained falls), including requests from neurologists and nonneurologists. EEGs were classified into (1) normal, (2) epileptiform discharges (spike/sharp waves), and (3) slow waves. The EEGs were separated according to gender and age. From 1,003 patients with the diagnosis of syncope, 899 (89.53%) were normal, 62 (6.18%) showed bilateral slow waves, 19 (1.89%) right slow waves, 18 (1.79%) epileptiform discharges, and 6 (0.6%) left slow waves. Epileptiform discharges only occurred among females. Left focal sharp waves were disclosed in 18 (50%), generalized discharges in 8 (44.4%), and right focal discharges in 1 (5.6%). Bilateral slow waves were more prevalent among adults. We conclude that EEG is not useful for evaluating the diagnosis of syncope because of its very low diagnostic yield. Patients with syncope must have a correct history and physical examination plus cardiovascular tests.
脑电图是一种广泛应用于神经和非神经评估的廉价检查方法。然而，脑电图的诊断价值存在一些限制，并且可能会增加医疗费用。晕厥的表现可能导致误诊，并且经常被误诊为癫痫。通常会进行脑电图检查，但一些研究表明，脑电图对诊断这种情况的价值不大。我们旨在确定脑电图在晕厥患者中的诊断价值。我们回顾性检查了 10408 名患者的脑电图记录。评估了所有诊断为晕厥（晕厥、惊厥性晕厥、意识丧失或突发性不明原因跌倒）患者的脑电图结果，包括神经科医生和非神经科医生的请求。脑电图分为（1）正常，（2）癫痫样放电（棘波/尖波）和（3）慢波。根据性别和年龄对脑电图进行分类。从 1003 名诊断为晕厥的患者中，899 名（89.53%）脑电图正常，62 名（6.18%）表现为双侧慢波，19 名（1.89%）右侧慢波，18 名（1.79%）癫痫样放电，6 名（0.6%）左侧慢波。癫痫样放电仅发生在女性中。18 名（50%）患者出现左侧局灶性尖波，8 名（44.4%）患者出现全面性放电，1 名（5.6%）患者出现右侧局灶性放电。双侧慢波在成年人中更为常见。我们得出结论，由于脑电图的诊断产出率非常低，因此对评估晕厥的诊断没有帮助。晕厥患者必须有正确的病史和体格检查以及心血管检查。
