Sinkin M V, Kaimovsky I L, Komoltsev I G, Trifonov I S, Shtekleyn A A, Tsygankova M E, Guekht A B
Sklifosovsky Research Institute of Emergenscy Medicine, Moscow, Russia.
Evdokimov Moscow State University of Medical Dentistry, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2020;120(8. Vyp. 2):10-16. doi: 10.17116/jnevro202012008210.
To determine the incidence of non-convulsive status epilepticus, epileptiform activity, rhythmic and periodic patterns in patients with acute stroke.
An analysis of electroencephalography (EEG) in 86 stroke patients in the neurointensive care unit of the tertiary medical center was performed. Criteria for starting EEG recording were epileptic seizures or clinical suspicion of uncontrolled epileptic status. The ictal-interictal continuum biomarkers and the diagnostic value of EEG for prediction of survival and recovery were assessed.
Pathological changes on EEG were recorded in 84% of patients. These patients showed the absence of the dominant occipital rhythm (66%) and hemispheric slowing (42%). Diffuse slowing below the theta range was observed in 41% of patients. EEG reactivity was absent in 20%. Sporadic epileptiform discharges were recorded in 36% of patients and rhythmic and periodic patterns in 26%. Reliable predictors of the unfavorable outcome were the absence of dominant occipital rhythm, lack of reactivity, and low amplitude of the background EEG. No association between the recording of epileptiform activity and the probability of death was shown.
The most useful EEG biomarkers for predicting survival are amplitude, dominant frequency of background EEG activity and reactivity to external stimulus. Sporadic epileptiform discharges, rhythmic, and periodic patterns are not mandatory associated with a negative prognosis in stroke patients.
确定急性卒中患者非惊厥性癫痫持续状态、癫痫样活动、节律性和周期性模式的发生率。
对一家三级医疗中心神经重症监护病房的86例卒中患者进行脑电图（EEG）分析。开始EEG记录的标准为癫痫发作或临床怀疑癫痫状态未得到控制。评估发作期-发作间期连续生物标志物以及EEG对生存和恢复的预测诊断价值。
84%的患者记录到EEG病理改变。这些患者表现为枕叶主导节律缺失（66%）和半球性慢波（42%）。41%的患者观察到θ波以下的弥漫性慢波。20%的患者EEG反应性缺失。36%的患者记录到散发性癫痫样放电，26%记录到节律性和周期性模式。不良预后的可靠预测因素是枕叶主导节律缺失、反应性缺乏以及EEG背景波幅低。癫痫样活动记录与死亡概率之间未显示关联。
预测生存最有用的EEG生物标志物是波幅、EEG背景活动的主导频率以及对外部刺激的反应性。散发性癫痫样放电、节律性和周期性模式并非一定与卒中患者的不良预后相关。
