Doerrfuss Jakob I, Kilic Tayfun, Ahmadi Michael, Holtkamp Martin, Weber Joachim E
Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Berlin Institute of Health (BIH), Berlin, Germany.
Clin EEG Neurosci. 2020 Mar;51(2):121-129. doi: 10.1177/1550059419875916. Epub 2019 Sep 19.
Currently, the relevance of EEG measurements in acute stroke patients is considered low in clinical practice. However, recent studies on the predictive value of EEG measurements after stroke for various outcomes may increase the role of EEG in patients with stroke. We aimed to review the current literature on the utility of EEG measurements after stroke as a tool to predict outcome and complications, focusing on studies in which the EEG measurement was performed in the acute phase after the event and in which long-term outcome measures were reported. In our literature review, we identified 4 different outcome measures (functional outcome, mortality, development of post-stroke cognitive decline, and development of post-stroke epilepsy) where studies on the utility of acute EEG measurements exist. There is a large body of evidence for the prediction of functional outcome, in which a multitude of associated quantitative and qualitative EEG parameters are described. In contrast, only few studies focus on mortality as outcome parameter. We found studies of high methodical quality on the prediction of post-stroke cognitive decline, though the number of patients in these studies often was small. The role of EEG as a prediction tool for seizures and epilepsy after stroke could increase after a recently published study, especially if its result can be incorporated into already existing post-stroke epilepsy prediction tools. In summary, EEG is useful for the prediction of functional outcome, mortality, development of post-stroke cognitive decline and epilepsy, even though there is a discrepancy between the large amount of studies on EEG in acute stroke patients and its underuse in clinical practice.
目前，在临床实践中，脑电图（EEG）测量对急性中风患者的相关性被认为较低。然而，最近关于中风后EEG测量对各种结局的预测价值的研究可能会增加EEG在中风患者中的作用。我们旨在回顾当前关于中风后EEG测量作为预测结局和并发症工具的文献，重点关注在事件发生后的急性期进行EEG测量且报告了长期结局指标的研究。在我们的文献综述中，我们确定了4种不同的结局指标（功能结局、死亡率、中风后认知功能下降的发生以及中风后癫痫的发生），针对这些指标存在关于急性EEG测量效用的研究。对于功能结局的预测有大量证据，其中描述了许多相关的定量和定性EEG参数。相比之下，只有少数研究将死亡率作为结局参数。我们发现了关于中风后认知功能下降预测的方法学质量较高的研究，尽管这些研究中的患者数量通常较少。最近一项发表的研究之后，EEG作为中风后癫痫发作和癫痫预测工具的作用可能会增加，特别是如果其结果能够纳入现有的中风后癫痫预测工具中。总之，EEG对于功能结局、死亡率、中风后认知功能下降和癫痫的预测是有用的，尽管急性中风患者中关于EEG的大量研究与其在临床实践中的未充分利用之间存在差异。
