Department of Neurology, University of Kentucky, Lexington, U.S.A.
Department of Physiology, University of Toronto, Ontario, Canada.
J Clin Neurophysiol. 2019 May;36(3):204-208. doi: 10.1097/WNP.0000000000000567.
Current literature suggests that longer duration of EEG recording increases the yield of detecting interictal epileptiform discharges. However, optimal duration for a repeat study in patients with initially normal 30-minute EEG is not clear. Thus, the purpose of this study is to determine whether a 2-hour EEG has a diagnostic advantage over a routine 30-minute EEG in detecting epileptiform abnormalities in patients who had a first normal 30-minute EEG.
This is a single-center, retrospective study done at UT Southwestern Medical Center at Dallas and Parkland Memorial Hospital. The data from 1997 to 2015 were extracted from the existing EEG report database for patients who had a first normal 30-minute EEG recording. EEG was interpreted by board-certified clinical neurophysiologists, who classified each EEG as normal or abnormal, with relevant subsequent subclassification.
Over 18 years, a total of 12,425 individual 30-minute EEGs were performed. Of these, 1,023 patients had at least one repeated EEG after the first normal EEG. Among these patients, 763 had a 30-minute EEG as the second study and 260 had a 2-hour EEG as the second study. The yield of epileptiform discharges was 3.3% in the 30-minute EEG group and 4.2% in the 2-hour EEG group (P = 0.5) in the repeating studies.
Two-hour EEG has a similar yield as 30-minute EEG to detect epileptiform discharges in patients with a normal 30-minute EEG.
目前的文献表明，脑电图（EEG）记录时间的延长会增加检测到发作间期癫痫样放电的可能性。然而，对于首次正常 30 分钟 EEG 的患者进行重复研究的最佳时间尚不清楚。因此，本研究旨在确定在首次正常 30 分钟 EEG 的患者中，2 小时 EEG 是否比常规 30 分钟 EEG 具有诊断优势，以检测出癫痫样异常。
这是一项在达拉斯德克萨斯大学西南医学中心和帕克兰纪念医院进行的单中心回顾性研究。从 1997 年至 2015 年，从现有的 EEG 报告数据库中提取了首次正常 30 分钟 EEG 记录的患者的数据。脑电图由经过委员会认证的临床神经生理学家进行解读，他们将每个脑电图分类为正常或异常，并进行相关的进一步细分。
在 18 年期间，共进行了 12425 次单独的 30 分钟 EEG。在这些患者中，有 1023 名患者在首次正常 EEG 后至少进行了一次重复 EEG。在这些患者中，763 名患者进行了 30 分钟 EEG 作为第二次研究，260 名患者进行了 2 小时 EEG 作为第二次研究。在重复研究中，30 分钟 EEG 组的癫痫样放电检出率为 3.3%，2 小时 EEG 组为 4.2%（P=0.5）。
在首次正常 30 分钟 EEG 的患者中，2 小时 EEG 与 30 分钟 EEG 检测癫痫样放电的检出率相似。
