Maruyama Azusa, Nagase Hiroaki
Department of Pediatric Neurology, Kobe Children's Hospital, Kobe, Hyogo.
No To Hattatsu. 2010 Jan;42(1):23-8.
This study sought to determine the effectiveness of continuous electroencephalogram (cEEG) monitoring for predicting neurological outcome among children with status epilepticus or altered consciousness in a pediatric intensive care unit (PICU). We detected nonconvulsive seizures and evaluated the relationship between electroencephalogram features and neurological outcome. Nonconvulsive seizures were detected in nearly 30% of the 79 patients who underwent cEEG monitoring, a rate that was similar to those seen in studies of adults. All patients who showed low voltage readings (< or = 10 micro V) at the time cEEG monitoring was started had poor neurological outcome (any changes in Pediatric Cerebral Performance Category Scale). Among patients who did not show low voltage readings, those who exhibited nonconvulsive seizures were more likely to have poor neurological outcome than those who did not. In a PICU, cEEG monitoring can help to predict neurological outcome in the early stage of treatment for children with status epilepticus or altered consciousness.
本研究旨在确定在儿科重症监护病房(PICU)中,连续脑电图(cEEG)监测对预测癫痫持续状态或意识改变儿童神经学转归的有效性。我们检测了非惊厥性癫痫发作,并评估脑电图特征与神经学转归之间的关系。在接受cEEG监测的79例患者中,近30%检测到非惊厥性癫痫发作,这一比例与成人研究中的比例相似。在开始cEEG监测时显示低电压读数(≤10微伏)的所有患者神经学转归均较差(小儿脑功能分类量表有任何变化)。在未显示低电压读数的患者中,出现非惊厥性癫痫发作的患者比未出现的患者更有可能出现较差的神经学转归。在PICU中,cEEG监测有助于在癫痫持续状态或意识改变儿童治疗的早期阶段预测神经学转归。