Department of Neurology and Clinical Neurophysiology, Radboud University Medical Center, Donders Institute for Brain Cognition and Behaviour, Nijmegen, The Netherlands.
Department of Neurology, Academic Center for Epileptology Kempenhaeghe & Maastricht UMC+, Heeze, The Netherlands.
Epilepsia. 2019 Aug;60(8):e88-e92. doi: 10.1111/epi.16289. Epub 2019 Jul 18.
To improve the diagnostic accuracy of electroencephalography (EEG) criteria for nonconvulsive status epilepticus (NCSE), external validation of the recently proposed Salzburg criteria is paramount. We performed an external, retrospective, diagnostic accuracy study of the Salzburg criteria, using EEG recordings from patients with and without a clinical suspicion of having NCSE. Of the 191 EEG recordings, 12 (12%) was classified as an NCSE according to the reference standard. In the validation cohort, sensitivity was 67% and specificity was 89%. The positive predictive value was 47% and the negative predictive value was 95%. Ten patients in the control group (n = 93) were false positive, resulting in a specificity of 89.2%. The interrater agreement between the reference standards and between the scorers of the Salzburg criteria was moderate; disagreement occurred mainly in patients with an epileptic encephalopathy. The Salzburg criteria showed a lower diagnostic accuracy in our external validation study than in the original design, suggesting that they cannot replace the current practice of careful weighing of both clinical and EEG information on an individual basis.
为了提高非惊厥性癫痫持续状态（NCSE）的脑电图（EEG）标准的诊断准确性，最近提出的萨尔斯堡标准的外部验证至关重要。我们对萨尔斯堡标准进行了外部、回顾性、诊断准确性研究，使用了有和无 NCSE 临床疑似症状的患者的 EEG 记录。在 191 份 EEG 记录中，根据参考标准，有 12 份（12%）被归类为 NCSE。在验证队列中，敏感性为 67%，特异性为 89%。阳性预测值为 47%，阴性预测值为 95%。对照组中有 10 名患者（n=93）为假阳性，特异性为 89.2%。参考标准之间以及萨尔斯堡标准评分者之间的观察者间一致性为中度；分歧主要发生在癫痫性脑病患者中。与原始设计相比，萨尔斯堡标准在我们的外部验证研究中的诊断准确性较低，这表明它们不能替代在个体基础上仔细权衡临床和 EEG 信息的当前实践。
