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先前全身麻醉或镇静及抗癫痫药物对犬无线视频脑电图诊断效用的影响。

Effect of prior general anesthesia or sedation and antiseizure drugs on the diagnostic utility of wireless video electroencephalography in dogs.

机构信息

Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.

Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.

出版信息

J Vet Intern Med. 2020 Sep;34(5):1967-1974. doi: 10.1111/jvim.15856. Epub 2020 Jul 13.

Abstract

BACKGROUND

Ambulatory wireless video electroencephalography (AEEG) is the method of choice to discriminate epileptic seizures from other nonepileptic episodes. However, the influence of prior general anesthesia (GA), sedation, or antiseizure drug (ASD) on the diagnostic ability of AEEG is unknown.

HYPOTHESIS/OBJECTIVES: The use of sedation/GA or ASD treatment before AEEG recording may affect the diagnostic ability of AEEG and the time to first abnormality on AEEG.

ANIMALS

A total of 108 client-owned dogs undergoing ambulatory AEEG for paroxysmal episodes.

METHODS

Retrospective cohort study. Proportions of diagnostic AEEG and time to first abnormality were compared between dogs that received sedation/GA or neither for instrumentation as well as dogs receiving at least 1 ASD and untreated dogs.

RESULTS

Ambulatory EEG was diagnostic in 60.2% of all dogs including 49% of the sedation/GA dogs and 68% of dogs that received neither (odds ratio [OR], 2.25; 95% confidence interval [CI], 1.02-5.00; P = .05). The AEEG was diagnostic in 51% of dogs receiving at least 1 ASD and 66% of untreated dogs (OR, 1.95; 95% CI, 0.9-4.3; P = .11). No difference was found in time to first abnormality between sedation/GA or neither or ASD-treated or untreated dogs (P = .1 and P = .3 respectively). Ninety-five percent of dogs had at least 1 abnormality within 277 minutes.

CONCLUSION AND CLINICAL IMPORTANCE

Sedation/GA and concurrent ASD administration were not identified as confounding factors for decreasing AEEG diagnostic capability nor did they delay the time to first abnormality. A 4-hour minimal recording period is recommended.

摘要

背景

动态无线视频脑电图(AEEG)是鉴别癫痫发作与其他非癫痫发作的首选方法。然而,在 AEEG 记录之前使用全身麻醉(GA)、镇静或抗癫痫药物(ASD)是否会影响 AEEG 的诊断能力尚不清楚。

假说/目的:在 AEEG 记录前使用镇静/GA 或 ASD 治疗可能会影响 AEEG 的诊断能力以及 AEEG 上首次出现异常的时间。

动物

共 108 只接受动态 AEEG 检查以诊断阵发性发作的患犬。

方法

回顾性队列研究。比较接受镇静/GA 或未接受镇静/GA 进行仪器操作的犬、接受至少 1 种 ASD 治疗的犬和未治疗的犬之间诊断性 AEEG 的比例和首次出现异常的时间。

结果

所有犬中,动态脑电图的诊断率为 60.2%,其中镇静/GA 犬的诊断率为 49%,未接受镇静/GA 犬的诊断率为 68%(比值比 [OR],2.25;95%置信区间 [CI],1.02-5.00;P =.05)。至少接受 1 种 ASD 治疗的犬和未治疗的犬中,AEEG 的诊断率分别为 51%和 66%(OR,1.95;95%CI,0.9-4.3;P =.11)。在首次出现异常的时间方面,镇静/GA 组与未接受镇静/GA 组或 ASD 治疗组与未治疗组之间无差异(P =.1 和 P =.3 分别)。95%的犬在 277 分钟内至少出现 1 次异常。

结论和临床意义

镇静/GA 和同时使用 ASD 并未被确定为降低 AEEG 诊断能力的混杂因素,也未延迟首次出现异常的时间。建议记录至少 4 小时。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cd70/7517491/84fd9d5cc385/JVIM-34-1967-g001.jpg

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