From the Department of Pediatric Emergency and Transport Services.
Interdisciplinary Pediatrics.
Pediatr Emerg Care. 2022 Sep 1;38(9):e1545-e1551. doi: 10.1097/PEC.0000000000002811. Epub 2022 Aug 9.
In the present study, we aimed to determine the changes in the administration rate of benzodiazepines for pediatric patients with suspected nonconvulsive status epilepticus (NCSE) before and after the introduction of simplified electroencephalography (sEEG) in the emergency department.
This retrospective cohort study included patients who were younger than 18 years and were admitted to the emergency department from August 1, 2009, to July 31, 2017, with altered level of consciousness and nonpurposeful movement of eyes or extremities after the cessation of convulsive status epilepticus. Patients with apparent persistent convulsions, those who were fully conscious on arrival, and those who were transferred from another hospital were excluded. The patients were categorized into pre and post groups based on the introduction of sEEG, and benzodiazepine administration was compared between the 2 groups.
During the study period, 464 patients with status epilepticus visited our emergency department and 69 and 93 patients fulfilling the study criteria were categorized into the pre and post groups, respectively. There were no significant differences in patient background characteristics between the 2 groups. Simplified electroencephalography was recorded in 52 patients in the post group. Benzodiazepines were administered in 44 of 69 patients (63.8%) in the pre group and 44 of 93 (47.3%) in the post group, and the benzodiazepine administration rate was significantly decreased after the introduction of sEEG ( P = 0.04). The hospitalization rate was significantly lower in the post group, but there were no significant differences in the rates of intensive care unit admission, reconvulsion after discharge, and final diagnoses between the 2 groups.
Simplified electroencephalography might aid in determining the need for anticonvulsant treatment for suspected NCSE in pediatric patients. Albeit not a definitive diagnostic tool, sEEG might be a reliable choice in the evaluation of pediatric patients with suspected NCSE.
本研究旨在探讨简化脑电图（sEEG）在急诊科应用前后，疑似非惊厥性癫痫持续状态（NCSE）患儿苯二氮䓬类药物给药率的变化。
本回顾性队列研究纳入 2009 年 8 月 1 日至 2017 年 7 月 31 日期间因惊厥性癫痫持续状态停止后出现意识水平改变和眼球或肢体不自主运动而入住急诊科的年龄小于 18 岁的患者。排除明显持续惊厥、入院时完全清醒和从其他医院转来的患者。根据 sEEG 的引入情况将患者分为引入前和引入后组，并比较两组患者的苯二氮䓬类药物给药情况。
研究期间，共有 464 例癫痫持续状态患者就诊于我院急诊科，符合研究标准的 69 例和 93 例患者分别归入引入前和引入后组。两组患者的背景特征无显著差异。引入后组中有 52 例患者进行了 sEEG 记录。引入前组中 69 例患者中有 44 例（63.8%）和引入后组中 93 例患者中有 44 例（47.3%）接受了苯二氮䓬类药物治疗，引入 sEEG 后苯二氮䓬类药物的使用率显著降低（P=0.04）。引入后组的住院率显著降低，但两组患者的重症监护病房入住率、出院后再发惊厥率和最终诊断率无显著差异。
sEEG 可能有助于确定疑似 NCSE 患儿是否需要抗惊厥治疗。尽管 sEEG 不是一种明确的诊断工具，但在评估疑似 NCSE 的儿科患者时，它可能是一种可靠的选择。
