Goenka Ajay, Boro Alexis, Yozawitz Elissa
Saul Korey Department of Neurology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY 10467, United States.
Saul Korey Department of Neurology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY 10467, United States.
Seizure. 2018 Feb;55:70-75. doi: 10.1016/j.seizure.2018.01.008. Epub 2018 Jan 31.
To assess the sensitivity of Persyst version 12 QEEG spectrograms to detect focal, focal with secondarily generalized, and generalized onset seizures.
A cohort of 562 seizures from 58 patients was analyzed. Successive recordings with 2 or more seizures during continuous EEG monitoring for clinical indications in the ICU or EMU between July 2016 and January 2017 were included. Patient ages ranged from 5 to 64 years (mean = 36 years). There were 125 focal seizures, 187 secondarily generalized and 250 generalized seizures from 58 patients analyzed. Seizures were identified and classified independently by two epileptologists. A correlate to the seizure pattern in the raw EEG was sought in the QEEG spectrograms in 4-6 h EEG epochs surrounding the identified seizures. A given spectrogram was interpreted as indicating a seizure, if at the time of a seizure it showed a visually significant departure from the pre-event baseline. Sensitivities for seizure detection using each spectrogram were determined for each seizure subtype.
Overall sensitivities of the QEEG spectrograms for detecting seizures ranged from 43% to 72%, with highest sensitivity (402/562,72%) by the seizure detection trend. The asymmetry spectrogram had the highest sensitivity for detecting focal seizures (117/125,94%). The FFT spectrogram was most sensitive for detecting secondarily generalized seizures (158/187, 84%). The seizure detection trend was the most sensitive for generalized onset seizures (197/250,79%).
Our study suggests that different seizure types have specific patterns in the Persyst QEEG spectrograms. Identifying these patterns in the EEG can significantly increase the sensitivity for seizure identification.
评估Persyst 12版定量脑电图（QEEG）频谱图检测局灶性发作、继发全面性发作和全面性发作起始的敏感性。
分析了来自58例患者的562次发作。纳入2016年7月至2017年1月期间在重症监护病房（ICU）或癫痫监测单元（EMU）因临床指征进行连续脑电图监测且有2次或更多次发作的连续记录。患者年龄在5至64岁之间（平均=36岁）。对58例患者分析得到125次局灶性发作、187次继发全面性发作和250次全面性发作。由两名癫痫专家独立识别和分类发作。在已识别发作周围4-6小时的脑电图时段的QEEG频谱图中寻找与原始脑电图中发作模式的相关性。如果在发作时给定的频谱图显示出与发作前基线有明显的视觉差异，则将其解释为表明发作。针对每种发作亚型确定使用每个频谱图检测发作的敏感性。
QEEG频谱图检测发作的总体敏感性范围为43%至72%，发作检测趋势的敏感性最高（402/562，72%）。不对称频谱图检测局灶性发作的敏感性最高（117/125，94%）。快速傅里叶变换（FFT）频谱图检测继发全面性发作最敏感（158/187，84%）。发作检测趋势对全面性发作起始最敏感（197/250，79%）。
我们的研究表明，不同类型的发作在Persyst QEEG频谱图中有特定模式。在脑电图中识别这些模式可显著提高发作识别的敏感性。
