Wang Shan, Jin Bo, Yang Linglin, Chen Cong, Ding Yao, Guo Yi, Wang Zhongjin, Ming Wenjie, Tang Yelei, Wang Shuang, Ding Meiping
Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Epilepsy Center, Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
J Clin Neurosci. 2017 Oct;44:214-217. doi: 10.1016/j.jocn.2017.06.071. Epub 2017 Jul 12.
The aim of this study was to determine the clinical importance and predictors of SCSs in a large population of patients with temporal epilepsy (TLE) undergoing video electroencephalographic (VEEG) monitoring. We reviewed the VEEG data of 327 consecutive patients with TLE admitted to our epilepsy center between August 2012 and January 2017. Demographic, electro-clinical, and neuroimaging data were recorded and re-analyzed. To our knowledge, this is the first study assessing SCSs recorded by long-term VEEG monitoring in patients with TLE. Twenty-seven of 327 (8.3%) patients exhibited SCSs during VEEG monitoring. Of these patients, 24 had both SCSs and clinical seizures. The mean duration of the SCSs was 23.18s (range: 5-1307s). Of the 27 patients with SCSs, 24 (88.9%) showed localizing value during the diagnostic process. Seventeen patients exhibited colocalization with clinical seizures, 4 showed useless localization related to clinical seizures, and 3 did not have clinical seizures. Sixteen patients (59.3%) experienced their first SCSs within the first 24h of monitoring and one had the first SCSs within 20min. Multivariate logistic regression analysis showed that age <18years at VEEG monitoring (OR=3.272, 95% CI=1.283-8.343, p=0.013) and bilateral IEDs (OR=4.558, 95% CI=1.982-10.477, p<0.001) were independently associated with the presence of SCSs. Thus, SCSs are not uncommon in patients with TLE, particularly those with age <18years or bilateral IEDs, and should be considered of significant clinical relevance during the diagnostic process.
本研究的目的是确定在接受视频脑电图（VEEG）监测的大量颞叶癫痫（TLE）患者中，癫痫性电持续状态（SCSs）的临床重要性及预测因素。我们回顾了2012年8月至2017年1月间连续入住我们癫痫中心的327例TLE患者的VEEG数据。记录并重新分析了人口统计学、电临床及神经影像学数据。据我们所知，这是第一项评估TLE患者通过长期VEEG监测记录到的SCSs的研究。327例患者中有27例（8.3%）在VEEG监测期间出现SCSs。在这些患者中，24例同时有SCSs和临床发作。SCSs的平均持续时间为23.18秒（范围：5 - 1307秒）。在27例有SCSs的患者中，24例（88.9%）在诊断过程中显示出定位价值。17例患者的SCSs与临床发作共定位，4例显示与临床发作无关的无用定位，3例没有临床发作。16例患者（59.3%）在监测的头24小时内首次出现SCSs，1例在20分钟内首次出现SCSs。多因素logistic回归分析显示，VEEG监测时年龄<18岁（OR = 3.272，95%CI = 1.283 - 8.343，p = 0.013）和双侧发作间期癫痫样放电（IEDs）（OR = 4.558，95%CI = 1.982 - 10.477，p<0.001）与SCSs的存在独立相关。因此，SCSs在TLE患者中并不少见，尤其是年龄<18岁或有双侧IEDs的患者，在诊断过程中应被视为具有重要临床意义。
