Oh Dan A, Kim Hyeyun, Bae Eun Kee
Department of Neurology, Inha University Hospital, Incheon, Korea.
Department of Neurology, International St. Mary Hospital, Catholic Kwandong Meical School, Incheon, Korea.
J Clin Neurol. 2018 Apr;14(2):212-214. doi: 10.3988/jcn.2018.14.2.212. Epub 2018 Feb 28.
Electroencephalography (EEG) is often used as a screening tool for selecting pilots despite controversy regarding its contribution to aviation safety. We investigated EEG abnormalities in Korean commercial pilot applicants in order to identify the usefulness of EEG screening in this population.
We retrospectively analyzed the EEG results of 740 unselected pilot applicants who underwent waking EEG at Inha University Hospital from January 2013 to May 2017. EEG recording was performed for 30 minutes, which included 3 minutes of hyperventilation and intermittent photic stimulation.
The pilot applicants were predominantly male (95.3%) and had a mean age of 27.8 years (range: 16-40 years). Nine of them (1.2%) exhibited EEG abnormalities; the most common abnormality (six applicants) was a small amount of generalized irregular slow activities, while the other three applicants (0.4%) exhibited epileptiform discharges, with two showing generalized spike-and-wave complexes and one showing a few spike-and-wave complexes in the left frontotemporal area. The two applicants with generalized spike-and-wave complexes were found to have experienced clinical seizures by a neurologist during detailed history-taking.
This study found that 2 of 740 pilot applicants (0.3%) were diagnosed with epilepsy by routine EEG screening in an unselected population. Considering the low predictive value of EEG without the relevant clinical history in an unselected healthy young population, our findings raise questions regarding the cost-effectiveness of the current EEG screening protocol applied to pilot applicants. We suggest that a more-targeted and standardized EEG screening approach be applied to pilot applicants with epilepsy risk factors or a seizure history as determined by thorough medical history-taking.
尽管脑电图（EEG）对航空安全的贡献存在争议，但它仍常被用作筛选飞行员的工具。我们调查了韩国商业飞行员申请者的脑电图异常情况，以确定脑电图筛查在该人群中的实用性。
我们回顾性分析了2013年1月至2017年5月在仁荷大学医院接受清醒脑电图检查的740名未经筛选的飞行员申请者的脑电图结果。脑电图记录持续30分钟，包括3分钟的过度换气和间歇性光刺激。
飞行员申请者以男性为主（95.3%），平均年龄为27.8岁（范围：16 - 40岁）。其中9人（1.2%）表现出脑电图异常；最常见的异常（6名申请者）是少量广泛性不规则慢波活动，另外3名申请者（0.4%）表现出癫痫样放电，其中2人表现为广泛性棘慢复合波，1人在左侧额颞区表现为少量棘慢复合波。在详细的病史询问中，发现有2名表现为广泛性棘慢复合波的申请者曾有临床癫痫发作，经神经科医生诊断。
本研究发现，在740名飞行员申请者中，有2人（0.3%）通过常规脑电图筛查在未筛选人群中被诊断为癫痫。考虑到在未筛选的健康年轻人群中，没有相关临床病史时脑电图的预测价值较低，我们的研究结果对目前应用于飞行员申请者的脑电图筛查方案的成本效益提出了质疑。我们建议，对于有癫痫危险因素或有癫痫发作史的飞行员申请者，应通过全面的病史询问来确定，采用更有针对性和标准化的脑电图筛查方法。
