Oguri Masayoshi, Saito Yoshiaki, Fukuda Chisako, Kishi Kazuko, Yokoyama Atsushi, Lee Sooyoung, Torisu Hiroyuki, Toyoshima Mitsuo, Sejima Hitoshi, Kaji Shunsaku, Hamano Shin-Ichiro, Okanishi Toru, Tomita Yutaka, Maegaki Yoshihiro
Department of Child Neurology, Institute of Neurological Science, Tottori University Faculty of Medicine, Yonago 683-8503, Japan.
†Department of Pathobiological Science and Technology, School of Life Sciences, Tottori University Faculty of Medicine, Yonago 683-8503, Japan.
Yonago Acta Med. 2016 Mar;59(1):1-14. Epub 2016 Apr 1.
To differentiate the features of electroencephalography (EEG) after status epileptics in febrile children with final diagnosis of either febrile seizure (FS) or acute encephalopathy for an early diagnosis.
We retrospectively collected data from 68 children who had status epilepticus and for whom EEGs were recorded within 120 h. These included subjects with a final diagnosis of FS (n = 20), epileptic status (ES; n = 11), acute encephalopathy with biphasic seizures and late reduced diffusion (AESD; n = 18), mild encephalopathy with a reversible splenial lesion (MERS; n = 7), other febrile encephalopathies (n = 10), hypoxic-ischemic encephalopathy (n = 1), and intracranial bleeding (n = 1). Initially, all EEGs were visually assessed and graded, and correlation with outcome was explored. Representative EEG epochs were then selected for quantitative analyses. Furthermore, data from AESD (n = 7) and FS (n = 16) patients for whom EEG was recorded within 24 h were also compared.
Although milder and most severe grades of EEG correlated with neurological outcome, the outcome of moderate EEG severity group was variable and was not predictable from usual inspection. Frequency band analysis revealed that solid delta power was not significantly different among the five groups (AESD, MERS, FS, ES and control), and that MERS group showed the highest theta band power. The ratios of delta/alpha and (delta + theta)/(alpha + beta) band powers were significantly higher in the AESD group than in other groups. The alpha and beta band powers in EEGs within 24 h from onset were significantly lower in the AESD group. The band powers and their ratios showed earlier improvement towards 24 h in FS than in AESD.
Sequential EEG recording up to 24 h from onset appeared to be helpful for distinction of AESD from FS before emergence of the second phase of AESD.
为鉴别热性惊厥（FS）或急性脑病最终诊断为热性惊厥持续状态的热性儿童癫痫发作后的脑电图（EEG）特征，以进行早期诊断。
我们回顾性收集了68例癫痫持续状态且在120小时内记录了脑电图的儿童的数据。这些儿童包括最终诊断为FS（n = 20）、癫痫持续状态（ES；n = 11）、伴有双相性惊厥和晚期弥散受限的急性脑病（AESD；n = 18）、伴有可逆性胼胝体病变的轻度脑病（MERS；n = 7）、其他热性脑病（n = 10）、缺氧缺血性脑病（n = 1）和颅内出血（n = 1）的患儿。最初，对所有脑电图进行视觉评估和分级，并探讨其与预后的相关性。然后选择代表性的脑电图片段进行定量分析。此外，还比较了在24小时内记录脑电图的AESD（n = 7）和FS（n = 16）患者的数据。
虽然较轻和最严重等级的脑电图与神经功能预后相关，但中度脑电图严重程度组的预后是可变的，通过常规检查无法预测。频段分析显示，五组（AESD、MERS、FS、ES和对照组）之间的固定δ波功率无显著差异，且MERS组的θ频段功率最高。AESD组的δ/α和（δ + θ）/（α + β）频段功率比显著高于其他组。AESD组发病后24小时内脑电图的α和β频段功率显著低于其他组。与AESD相比，FS组的频段功率及其比值在24小时时改善得更早。
发病后24小时内连续记录脑电图似乎有助于在AESD第二阶段出现之前将其与FS区分开来。
