Weber Amanda B, Albert Dara V, Yin Han, Held Timothy P, Patel Anup D
*Department of Pediatrics, Division of Pediatric Neurology, Nationwide Children's Hospital, The Ohio State University, Columbus, Ohio, U.S.A.; and †Department of Biostatistics Shared Resources, Nationwide Children's Hospital, Columbus, Ohio, U.S.A.
J Clin Neurophysiol. 2017 Jan;34(1):65-68. doi: 10.1097/WNP.0000000000000307.
Strategies for diagnosing electrical status epilepticus during slow-wave sleep (ESES) vary among interpreting neurologists. Our aim was to evaluate if the spike-wave index (SWI) for the first 100 seconds of sleep is reflective of the SWI when compared with a conventional method.
We reviewed EEGs from 2005 to 2011 that were considered diagnostic of ESES based on unspecified methods. The SWI for the first nonrapid eye movement sleep cycle (long method) was calculated by two neurophysiologists. Two different neurophysiologists calculated SWI for the first 100 seconds of sleep (short method). For the purposes of this study, ESES was defined as an SWI of >85%. The two SWI scores were compared.
Fourteen EEGs were reviewed. Despite being considered by the initial interpreter as diagnostic of ESES, only 4 of the studies had an SWI of >85% based on each of the methods. For a diagnosis of ESES, the sensitivity of the short method is 80% and the specificity is 89%. Wilcoxon signed rank test was used to compare the long and short methods. A P value of 0.70 indicates no significant difference between the methods. Additionally, the Spearman correlation coefficient is 0.553 (P = 0.04), indicating moderate correlation between the methods.
The SWI for the first 100 seconds of nonrapid eye movement sleep is predictive of the SWI for the entire first sleep cycle with a good sensitivity and specificity in our cohort. This suggests an alternative method for diagnosing ESES, which is comparable to analysis of a full night of sleep.
慢波睡眠期癫痫性电持续状态（ESES）的诊断策略在不同的神经科解读医生中存在差异。我们的目的是评估与传统方法相比，睡眠开始后100秒的棘慢波指数（SWI）是否能反映整体的SWI。
我们回顾了2005年至2011年基于未明确方法诊断为ESES的脑电图。两名神经生理学家计算了第一个非快速眼动睡眠周期的SWI（长方法）。另外两名不同的神经生理学家计算了睡眠开始后100秒的SWI（短方法）。在本研究中，ESES定义为SWI>85%。比较了两种SWI评分。
共回顾了14份脑电图。尽管最初的解读医生认为这些脑电图可诊断为ESES，但基于每种方法，只有4项研究的SWI>85%。对于ESES的诊断，短方法的敏感性为80%，特异性为89%。采用Wilcoxon符号秩检验比较长方法和短方法。P值为0.70表明两种方法之间无显著差异。此外，Spearman相关系数为0.553（P = 0.04），表明两种方法之间存在中度相关性。
在我们的队列中，非快速眼动睡眠开始后100秒的SWI能够预测整个第一个睡眠周期的SWI，具有良好的敏感性和特异性。这提示了一种诊断ESES的替代方法，其与整夜睡眠分析具有可比性。
