小尖波的临床意义：对癫痫监测单元909例患者的回顾性研究

The clinical significance of small sharp spikes: A retrospective study of 909 patients in epilepsy monitoring unit.

作者信息

Chen Ziyi, Issa Naoum P, Wu Shasha, Liu Xi, Sun Taixin, Bodnya Julia, Rose Sandra, Tao James X

机构信息

Department of Neurology, The University of Chicago, Chicago, IL, 60637, USA.

出版信息

Epilepsy Res. 2020 Dec;168:106477. doi: 10.1016/j.eplepsyres.2020.106477. Epub 2020 Oct 5.

DOI:10.1016/j.eplepsyres.2020.106477

PMID:33096313

Abstract

OBJECTIVES

To determine the incidence and clinical significance of small sharp spikes (SSS) in the patient population of the adult Epilepsy Monitoring Unit (EMU).

METHODS

This is a retrospective study of EEG data and medical records from consecutive patients who underwent video-EEG recording in the adult EMU from March 2013 to February 2019. SSS, interictal epileptiform discharges (IEDs), and ictal patterns were identified.

RESULTS

Of the 909 patients reviewed, SSS were observed in110 (12.1 %) patients. Epilepsy was present in 101 of the 110 (91.8 %) patients with SSS and in 441 of the 799 (55.2 %) patients without SSS. The incidence of epilepsy was significantly higher in patients with SSS than in those without SSS (OR = 9.1, 95 % CI: 4.5-18.3, P < 0.01). The sensitivity of SSS for epilepsy was 18.6 % and the specificity was 97.5 %. The incidence of SSS was strongly correlated with the frequency of IEDs (OR 1.89; 95 %CI: 1.60-2.24, P < 0.01). When both present, SSS and IEDs were co-lateralized in the same hemisphere.

CONCLUSIONS

There is a statistically significant association between SSS and focal epilepsy. SSS have similar clinical implications to IEDs in the lateralization and localization of temporal lobe seizures. SSS can be an epileptiform EEG pattern for temporal lobe epilepsy.

摘要

目的

确定成人癫痫监测单元（EMU）患者群体中小尖峰（SSS）的发生率及其临床意义。

方法

这是一项对2013年3月至2019年2月在成人EMU接受视频脑电图记录的连续患者的脑电图数据和病历进行的回顾性研究。识别出SSS、发作间期癫痫样放电（IEDs）和发作期模式。

结果

在909例接受评估的患者中，110例（12.1%）患者观察到SSS。110例有SSS的患者中有101例（91.8%）患有癫痫，799例无SSS的患者中有441例（55.2%）患有癫痫。有SSS的患者癫痫发生率显著高于无SSS的患者（OR = 9.1，95%CI：4.5 - 18.3，P < 0.01）。SSS对癫痫的敏感性为18.6%，特异性为97.5%。SSS的发生率与IEDs的频率密切相关（OR 1.89；95%CI：1.60 - 2.24，P < 0.01）。当SSS和IEDs同时存在时，它们在同一半球同侧。