Gong P, Yang Z X, Xue J, Qian P, Yang H P, Liu X Y, Bian K G
Department of Pediatrics, Peking University First Hospital, Beijing 100034, China.
Institute of Network Computing and Information Systems, Peking University, Beijing 100871, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2018 Apr 18;50(2):213-220.
To investigate the clinical significance of high-frequency oscillations (HFOs) on scalp electroencephalography (EEG) in patients with epileptic encephalopathy with continuous spike-and-wave during sleep (CSWS).
Twenty-one CSWS patients treated for epilepsy from January 2006 to December 2016 in Pediatric Department of Peking University First Hospital were enrolled into the study. Selected clinical variables including gender, age parameters, seizure frequencies and antiepileptic drugs were compared between (a). HFO-positive group and HFO-negative group before methylprednisolone treatment and (b). excellent seizure outcome group and not-excellent seizure outcome group after methylprednisolone treatment. Interictal HFOs and spikes in pre- and post-methylprednisolone scalp EEG were measured and analyzed.
Before methylprednisolone treatment, there were 12 of 21 (57%) CSWS patients had HFOs, with a mean value 43.17 per 60 s per patient. The 12 patients with HFOs tended to have more frequent epileptic negative myoclonus/atonic/myoclonus/atypical absences than those without HFOs in a month before methylprednisolone treatment. A total of 518 HFOs and 22 592 spikes were found in the pre-methylprednisolone EEG data of 21 patients, and 441 HFOs (86%) were associated with spikes. The highest amplitudes of HFOs were significantly positively correlated with that of spikes (r=0.279, P<0.001). Rates reduced by methylprednisolone treatment were statistically significant for both HFOs (P=0.002) and spikes (P=0.006). The percentage of reduction was 91% (473/518) and 39% (8 905/22 592) for spikes and HFOs, respectively. The percentage of spike and HFOs changes was respectively 100% decrease and 47% decrease in the excellent seizure outcome group, and they were 79% decrease and 18% increase in the not-excellent seizure outcome group.
Prevalence of HFOs might reflect some aspect of epileptic activity. HFOs were more sensitive to methylprednisolone treatment than spikes and had a good correlation with the prognosis of seizures, and HFOs could be applied to assess epilepsy severity and antiepileptic therapy.
探讨睡眠期持续性棘慢波癫痫性脑病（CSWS）患者头皮脑电图（EEG）高频振荡（HFOs）的临床意义。
选取2006年1月至2016年12月在北京大学第一医院儿科治疗的21例CSWS癫痫患者纳入研究。比较（a）甲基强的松龙治疗前HFOs阳性组和HFOs阴性组之间以及（b）甲基强的松龙治疗后癫痫发作结局良好组和癫痫发作结局不佳组之间的选定临床变量，包括性别、年龄参数、癫痫发作频率和抗癫痫药物。测量并分析甲基强的松龙治疗前后头皮EEG的发作间期HFOs和棘波。
甲基强的松龙治疗前，21例CSWS患者中有12例（57%）出现HFOs，平均每位患者每60秒43.17次。在甲基强的松龙治疗前的一个月内，12例有HFOs的患者比无HFOs的患者癫痫性负性肌阵挛/失张力/肌阵挛/非典型失神发作更频繁。在21例患者的甲基强的松龙治疗前EEG数据中，共发现518次HFOs和22592次棘波，其中441次HFOs（86%）与棘波相关。HFOs的最高波幅与棘波的最高波幅呈显著正相关（r=0.279，P<0.001）。甲基强的松龙治疗后HFOs（P=0.002）和棘波（P=0.006）的减少率具有统计学意义。棘波和HFOs的减少百分比分别为91%（473/518）和39%（8905/22592）。癫痫发作结局良好组棘波和HFOs变化的百分比分别为100%降低和47%降低，癫痫发作结局不佳组分别为79%降低和18%升高。
HFOs的发生率可能反映癫痫活动的某些方面。HFOs对甲基强的松龙治疗比棘波更敏感，且与癫痫发作的预后有良好相关性，HFOs可用于评估癫痫严重程度和抗癫痫治疗效果。
