Tang Liwei, Xiao Zheng
Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, China; Department of Neurology, The Third Hospital of MianYang, China.
Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, China.
Clin Neurophysiol. 2017 Feb;128(2):297-302. doi: 10.1016/j.clinph.2016.11.024. Epub 2016 Dec 5.
The discontinuation of antiepileptic drugs (AEDs) is an important treatment decision for epilepsy patients who have been seizure-free for 2years or longer. Some patients experience seizures relapse after AED withdrawal. The prognostic value of electroencephalograms (EEGs) for seizure relapse following AED withdrawal is controversial. To our knowledge, this is the first meta-analysis to address whether EEG data can be used to guide the discontinuation of AEDs.
We performed a meta-analysis of cohort studies that reported original EEG data from before AED withdrawal and recurrence after AED-withdrawal. The quality of each study was assessed using the Newcastle-Ottawa Scale.
Fifteen studies including a total of 2349 participants were included in this meta-analysis. This meta-analysis of 15 studies demonstrates that an abnormal electroencephalogram was a predictor of the risk of relapse. Additionally, paroxysmal, slowing, spike and wave activities on electroencephalograms were associated with increased risk of relapse.
We reveal that abnormal EEG records, particularly paroxysmal abnormalities, before AED withdrawal predicted a high risk of relapse. Slowing and spike and wave activities also exhibited moderate predictive values.
Our findings suggest that, EEGs might be an important prognostic tool for antiepileptic drug reduction.
对于已无癫痫发作达两年或更长时间的癫痫患者而言，停用抗癫痫药物（AEDs）是一项重要的治疗决策。部分患者在停用AEDs后会出现癫痫复发。脑电图（EEGs）对停用AEDs后癫痫复发的预后价值存在争议。据我们所知，这是第一项探讨EEG数据是否可用于指导停用AEDs的荟萃分析。
我们对队列研究进行了荟萃分析，这些研究报告了停用AEDs前的原始EEG数据以及停用AEDs后的复发情况。使用纽卡斯尔-渥太华量表评估每项研究的质量。
本荟萃分析纳入了15项研究，共计2349名参与者。对这15项研究的荟萃分析表明，脑电图异常是复发风险的一个预测指标。此外，脑电图上的阵发性、慢波、棘波和尖波活动与复发风险增加相关。
我们发现，停用AEDs前脑电图记录异常，尤其是阵发性异常，预示着复发风险较高。慢波以及棘波和尖波活动也显示出中度预测价值。
我们的研究结果表明，脑电图可能是减停抗癫痫药物的一项重要预后工具。
