Department of Neurology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Clin EEG Neurosci. 2020 Nov;51(6):420-425. doi: 10.1177/1550059420925962. Epub 2020 Jun 2.
The objective of this work was to study the electroencephalographic (EEG) grading of neuronal dysfunction in encephalopathy of various etiologies and assess their association with clinical outcomes.
This retrospective cross-sectional study was performed between June and November 2018 at the Neurology Department of King Fahd Hospital of University, Kingdom of Saudi Arabia (KSA) and involved a review and analysis of EEG and medical records pertaining to 222 patients in whom encephalopathy was diagnosed.
In patients suffering from encephalopathy, advanced age ( = .01), low Glasgow Coma Scale (GCS) scores ( = .00), and certain etiologies, namely hypoxic-ischemic encephalopathy (HIE) ( = .00), septic encephalopathy ( = .01), and other illnesses ( = .00), were significantly associated with unfavorable clinical outcomes, whereas traumatic brain injury (TBI) ( = .01) and GCS >7 ( = .00) were associated with favorable outcomes. Among different etiologies, EEG grade I ( = .02) and grade IV ( = .04) neuronal dysfunction was significantly associated with TBI while grade III ( = .05) and grade V ( = .02) neuronal dysfunction was significantly associated with HIE. Grade I ( = .03) neuronal dysfunction was mostly observed in septic encephalopathy cases, while patients suffering from other illnesses were also found to have grade I ( = .04) and grade IV ( = .05) neuronal dysfunction based on their EEG.
EEG is being conducted routinely to determine the course and severity of various forms of encephalopathy. However, the clinical implications of EEG grading for neuronal dysfunction are largely dependent on underlying etiology and other clinical parameters, such as age and GCS score. Further larger prospective cohort studies involving other important prognostic parameters and continuous EEG monitoring are thus needed.
本研究旨在探讨不同病因脑病患者的脑电（EEG）神经元功能障碍分级，并评估其与临床结局的相关性。
本回顾性横断面研究于 2018 年 6 月至 11 月在沙特阿拉伯王国法赫德国王大学附属医院神经科进行，纳入了 222 例诊断为脑病的患者，对其 EEG 记录和病历进行了回顾和分析。
在脑病患者中，高龄（ =.01）、格拉斯哥昏迷量表（GCS）评分较低（ =.00）以及特定病因（如缺氧缺血性脑病[HIE]， =.00；脓毒症性脑病， =.01；其他疾病， =.00）与不良临床结局显著相关，而创伤性脑损伤（TBI）（ =.01）和 GCS＞7（ =.00）与良好结局相关。在不同病因中，脑电图 I 级（ =.02）和 IV 级（ =.04）神经元功能障碍与 TBI 显著相关，而 III 级（ =.05）和 V 级（ =.02）神经元功能障碍与 HIE 显著相关。I 级（ =.03）神经元功能障碍主要见于脓毒症性脑病患者，而其他疾病患者的 EEG 也显示存在 I 级（ =.04）和 IV 级（ =.05）神经元功能障碍。
EEG 常规用于确定各种形式脑病的病程和严重程度。然而，EEG 分级对神经元功能障碍的临床意义在很大程度上取决于潜在的病因和其他临床参数，如年龄和 GCS 评分。因此，需要进一步开展更大规模的前瞻性队列研究，纳入其他重要的预后参数和连续 EEG 监测。
