McCreadie R G, Phillips K, Robinson A D, Gilhooly G, Crombie W
Crichton Royal Hospital, Dumfries.
Br J Psychiatry. 1989 Feb;154:229-31. doi: 10.1192/bjp.154.2.229.
Electroencephalographic (EEG) monitoring was carried out in 169 bilateral and 114 unilateral applications of electroconvulsive therapy (ECT), given to 51 patients in an everyday setting within the National Health Service by junior medical staff. In 2.5% of bilateral and 8% of unilateral applications there was disagreement between clinical and EEG assessment as to whether a fit had occurred. When an EEG fit was said to have occurred only if it lasted longer than 25 seconds, then disagreement rose to 7% in bilateral and 28% in unilateral applications; disagreement was higher with unilateral applications, as they produced more short fits than bilateral applications. If future work shows duration of seizure is clearly associated with clinical efficacy, it is suggested the case for routine EEG monitoring is greatly strengthened.
在国民医疗服务体系中，初级医务人员在日常工作环境下，对51名患者进行了169次双侧和114次单侧电休克治疗（ECT），并同时进行了脑电图（EEG）监测。在双侧治疗中，2.5%的病例以及单侧治疗中8%的病例，临床评估与脑电图评估在是否发生痉挛方面存在分歧。若将脑电图显示的痉挛定义为持续超过25秒，那么双侧治疗中的分歧率升至7%，单侧治疗中的分歧率升至28%；单侧治疗的分歧率更高，因为其产生的短痉挛比双侧治疗更多。如果未来的研究表明癫痫发作持续时间与临床疗效明显相关，那么常规脑电图监测的必要性将大大增强。
