Swatzyna Ronald J, Tarnow Jay D, Turner Robert P, Roark Alexandra J, MacInerney Erin K, Kozlowski Gerald P
*Tarnow Center for Self-Management, Houston, Texas, U.S.A.; †Network Neurology LLC, Charleston, South Carolina, U.S.A.; and ‡Department of Clinical Psychology, Saybrook University, Oakland, California, U.S.A.
J Clin Neurophysiol. 2017 May;34(3):230-235. doi: 10.1097/WNP.0000000000000365.
Data from an EEG is not commonly used by psychiatrists to plan treatment and medication. However, EEG abnormalities such as isolated epileptiform discharges are found to be more prevalent in psychiatric patients, particularly those diagnosed with autism spectrum disorder (ASD). Most medications prescribed for ASD lower seizure threshold and increase side effects. Therefore, it may be prudent to order an EEG for ASD cases, especially those categorized as refractory.
The data set was obtained from a multidisciplinary practice that treats a wide variety of neuroatypical children and adolescent refractory patients. This study investigated 140 nonepileptic subjects diagnosed with ASD, aged 4 to 25 years. Visual inspection of the EEG was performed to search for paroxysmal, focal, or lateralizing patterns.
Of the 140 subjects, the EEG data identified 36% with isolated epileptiform discharges. The χ analysis found no significant difference between genders among the three age groups. Findings indicated a high prevalence of isolated epileptiform discharges among individuals with ASD.
Our results find that compared with the healthy population, a large number of patients with ASD have isolated epileptiform discharges despite never having a seizure. Our findings support the use of EEG in children, adolescents, and young adults with ASD, regardless of gender or age. This is particularly true for those who exhibit aggressive behaviors or those who have failed previous medication attempts with stimulants, antidepressants, and/or antipsychotics.
精神科医生通常不会使用脑电图（EEG）数据来规划治疗和用药。然而，人们发现脑电图异常，如孤立性癫痫样放电，在精神病患者中更为普遍，尤其是那些被诊断患有自闭症谱系障碍（ASD）的患者。大多数用于治疗ASD的药物会降低癫痫阈值并增加副作用。因此，对于ASD病例，尤其是那些被归类为难治性的病例，进行脑电图检查可能是谨慎的做法。
数据集来自一个多学科诊所，该诊所治疗各种神经发育异常的儿童和青少年难治性患者。本研究调查了140名年龄在4至25岁之间、被诊断患有ASD的非癫痫患者。通过目视检查脑电图，寻找阵发性、局灶性或定位性模式。
在140名受试者中，脑电图数据显示36%的人有孤立性癫痫样放电。χ分析发现，三个年龄组的性别之间没有显著差异。研究结果表明，ASD患者中孤立性癫痫样放电的发生率很高。
我们的研究结果发现，与健康人群相比，大量ASD患者尽管从未发作过癫痫，但仍有孤立性癫痫样放电。我们的研究结果支持对患有ASD的儿童、青少年和年轻人使用脑电图，无论其性别或年龄。对于那些表现出攻击性行为的人，或者那些之前使用兴奋剂、抗抑郁药和/或抗精神病药治疗失败的人来说尤其如此。
