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可能散发型克雅氏病的脑电图观察

EEG Observations in Probable Sporadic CJD.

作者信息

Mundlamurri Ravindranadh Chowdary, Shah Rutul, Adiga M Sharath, Chatterjee Aparijita, Gautham Bhargava, Raghavendra K, Ajay A, Mahadevan Anita, Kulanthaivelu Karthik, Sinha Sanjib

机构信息

Department of Neurology, NIMHANS, Bengaluru, Karnataka, India.

Department of Neuropathology, NIMHANS, Bengaluru, Karnataka, India.

出版信息

Ann Indian Acad Neurol. 2020 Nov-Dec;23(6):760-766. doi: 10.4103/aian.AIAN_672_20. Epub 2020 Dec 18.

Abstract

INTRODUCTION

Sporadic Creutzfeldt Jakob Disease, the most common reported prion disease, is a fatal neurodegenerative disease caused by the misfolding of protein PrP to PrP. EEG is the first test to support the clinical diagnosis of sporadic CJD (sCJD). This study is carried out to describe the comprehensive electroencephalography changes in a cohort of patients with probable sCJD from south India.

METHODOLOGY

This retrospective observational study is conducted by reviewing case records from 2013-2020. Demographic, clinical, imaging details were noted. Electroencephalogram (EEG) recordings were retrieved and reviewed independently by two qualified epileptologists and the findings were visually analyzed and correlated with clinical and imaging abnormalities.

RESULTS

Fifty patients with probable sCJD with the availability of artefact-free EEG were included in the study. The mean age was 59.76 ± 8.17 years and M: F was 31:19. Magnetic resonance imaging (MRI) brain showed abnormality defining CJD in 48/50, i.e., 96%patients. EEG showed specific and or nonspecific abnormalities in 88%. The specific abnormalities, i.e., periodic sharp wave complexes (PSWC), were noted 66%. PSWC were mostly asymmetric (90%) and more frequently seen in the right hemisphere (57.6%). Amplitude maximum in the occipital region was noted in 42.4% and in frontal region in 36.4%. The sensitivity of EEG specific abnormalities to diagnose probable sCJD according to CDC 2018 criteria with positive MRI findings was 68.75%.

CONCLUSION

This study showed that EEG is a relatively inexpensive and sensitive tool and assists in the diagnosis of sCJD. However, it can be normal or show nonspecific abnormalities in the early stages of the disease.

摘要

引言

散发性克雅氏病是最常见的报道的朊病毒病,是一种由蛋白质PrP错误折叠为PrPsc引起的致命性神经退行性疾病。脑电图(EEG)是支持散发性克雅氏病(sCJD)临床诊断的首要检查。本研究旨在描述一组来自印度南部可能患有sCJD患者的综合脑电图变化。

方法

本回顾性观察研究通过回顾2013年至2020年的病例记录进行。记录了人口统计学、临床和影像学细节。脑电图记录由两名合格的癫痫专家独立检索和审查,对结果进行视觉分析,并与临床和影像学异常进行关联。

结果

本研究纳入了50例可能患有sCJD且脑电图无伪迹的患者。平均年龄为59.76±8.17岁,男性与女性比例为31:19。脑部磁共振成像(MRI)显示48/50例(即96%的患者)有符合克雅氏病的异常表现。脑电图显示88%的患者有特异性和/或非特异性异常。观察到特异性异常,即周期性尖锐波复合波(PSWC)的患者占66%。PSWC大多不对称(90%),且更常见于右半球(57.6%)。42.4%的患者枕区波幅最大,36.4%的患者额区波幅最大。根据2018年美国疾病控制与预防中心(CDC)标准及MRI阳性结果,脑电图特异性异常对诊断可能的sCJD的敏感性为68.75%。

结论

本研究表明,脑电图是一种相对廉价且敏感的工具,有助于sCJD的诊断。然而,在疾病早期脑电图可能正常或显示非特异性异常。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eef4/7900740/8418495ed9d4/AIAN-23-760-g001.jpg

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