Department of Neurology and Neurosciences, Stanford Medical Center, Palo Alto, CA, USA.
Department of Neurology and Neurosciences, Stanford Medical Center, Palo Alto, CA, USA.
Clin Neurophysiol. 2018 Apr;129(4):783-786. doi: 10.1016/j.clinph.2018.01.058. Epub 2018 Feb 3.
To assess electroencephalography (EEG) changes during tilt table testing in syncope and other orthostatic syndromes.
We retrospectively reviewed consecutive tilt table studies with simultaneous EEG from April 2014 to May 2016 at our center. All patients had video EEG during tilt table. All patients had at least 10 min of head up tilt unless they had syncope or did not tolerate the study. Video EEG was interpreted by epileptologists.
Eighty-seven patients met the inclusion criteria. Mean age was 45 years, and 55 were women. Seven patients (∼8%) had syncope during tilt table, 11 patients (∼12%) had significant neurogenic orthostatic hypotension and a separate group of 11 patients (∼12%) had significant orthostatic tachycardia. Valsalva responses were abnormal in 7 of the 11 patients with orthostatic hypotension, suggesting an underlying neurogenic orthostatic hypotension. Visually discernable EEG changes were seen in only 3 patients (∼43%) who had syncope and in 1 patient (∼9%) with orthostatic tachycardia.
Qualitative EEG analysis based on visual inspection during tilt table study revealed abnormalities in less than half the patients with syncope and a very small fraction with orthostatic tachycardia.
Routine qualitative EEG recording might not be clinically useful during tilt table studies.
评估晕厥和其他直立性综合征患者倾斜试验期间脑电图（EEG）的变化。
我们回顾性分析了 2014 年 4 月至 2016 年 5 月在我院进行的连续倾斜台研究，这些研究均同步进行 EEG。所有患者在倾斜台期间均进行视频 EEG 检查。所有患者均进行至少 10 分钟的头高位倾斜，除非出现晕厥或无法耐受研究。视频 EEG 由癫痫专家进行解读。
87 例患者符合纳入标准。平均年龄为 45 岁，55 例为女性。7 例（约 8%）患者在倾斜台期间出现晕厥，11 例（约 12%）患者出现明显的神经源性直立性低血压，另有 11 例（约 12%）患者出现明显的直立性心动过速。11 例直立性低血压患者中有 7 例（约 70%）的瓦尔萨尔瓦反应异常，提示存在潜在的神经源性直立性低血压。仅在 3 例（约 43%）晕厥患者和 1 例（约 9%）直立性心动过速患者中观察到可分辨的脑电图变化。
基于倾斜台研究期间的视觉检查进行的定性 EEG 分析显示，晕厥患者中不到一半、直立性心动过速患者中仅有一小部分存在异常。
常规定性 EEG 记录在倾斜台研究中可能没有临床意义。
