Park Kang Min, Shin Kyong Jin, Ha Sam Yeol, Park JinSe, Kim Si Eun, Kim Hyung Chan, Lee Joon Won, Kim Sung Eun
Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-ro 875, Haeundae-gu, Busan 612-896, Republic of Korea.
Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-ro 875, Haeundae-gu, Busan 612-896, Republic of Korea.
Seizure. 2015 Feb;25:33-6. doi: 10.1016/j.seizure.2014.12.003. Epub 2014 Dec 12.
The objective of this study was to determine whether the adverse effects of antiepileptic-drugs could be assessed by the eye movements of epilepsy patients.
This study was performed prospectively in a single tertiary hospital. The inclusion criteria for this study were as follows: (1) consecutive patients with epilepsy taking antiepileptic-drugs regularly for at least 1 year, (2) the absence of structural lesions on MRI, (3) an age ≥16 years old, (4) not using medications that could influence eye movement, and (5) a normal neurological examination. The latency, peak velocity and accuracy of the saccades and the gain of the pursuits were recorded by video-based electro-oculography. We analyzed the differences in the parameters of the eye movements for 75 patients with epilepsy and 20 normal controls matched for age and sex.
The total latency (1017.7 ± 148.9 ms vs. 1150.7 ± 106.6 ms, p=0.0003) and accuracy [370.7% (95% CI 364.1-376.4%, range 306-408.2%), 92.7% as total accuracy normalized value vs. 383.6% (95% CI 378.8-398%, range 322.9-417.4%), 95.9% as total accuracy normalized value, p=0.0005] were significantly different between the patients with epilepsy and normal controls. For the detection of nystagmus with video-based electro-oculography, the clear cutoff values of total accuracy (≤388.7%, 97.2% as total accuracy normalized value) revealed 93.4% sensitivity and 28.6% specificity, and the clear cutoff values of total latency (≤1005.5 ms) showed 49.2% sensitivity and 78.6% specificity.
The total latency and accuracy of video-based electro-oculography may be screened to identify patients with a high risk of adverse effects with antiepileptic-drugs.
本研究的目的是确定癫痫患者的眼球运动是否可用于评估抗癫痫药物的不良反应。
本研究在一家三级医院进行前瞻性研究。本研究的纳入标准如下：（1）连续癫痫患者规律服用抗癫痫药物至少1年；（2）MRI检查无结构性病变；（3）年龄≥16岁；（4）未使用可能影响眼球运动的药物；（5）神经学检查正常。通过基于视频的眼电图记录扫视的潜伏期、峰值速度和准确性以及跟踪的增益。我们分析了75例癫痫患者和20例年龄和性别匹配的正常对照者眼球运动参数的差异。
癫痫患者与正常对照者的总潜伏期（1017.7±148.9毫秒对1150.7±106.6毫秒，p = 0.0003）和准确性[370.7%（95%CI 364.1 - 376.4%，范围306 - 408.2%），总准确性归一化值为92.7%对383.6%（95%CI 378.8 - 398%，范围322.9 - 417.4%），总准确性归一化值为95.9%，p = 0.0005]有显著差异。对于基于视频的眼电图检测眼球震颤，总准确性的明确临界值（≤388.7%，总准确性归一化值为97.2%）显示敏感性为93.4%，特异性为28.6%，总潜伏期的明确临界值（≤1005.5毫秒）显示敏感性为49.2%，特异性为78.6%。
基于视频的眼电图的总潜伏期和准确性可用于筛查有抗癫痫药物不良反应高风险的患者。
