Ashour Mohammed, Minato Erica, Alawadhi Abdulla, Berrahmoune Saoussen, Simard-Tremblay Elisabeth, Poulin Chantal, Myers Kenneth A
Division of Child Neurology, Department of Pediatrics, Montreal Children's Hospital, McGill University, 1001 Décarie Blvd, Montreal, Quebec H4A 3J1, Canada.
Department of Pediatrics, University of Jeddah, Hamzah Ibn Al Qasim St, Al Sharafeyah, Jeddah, Saudi Arabia.
Heliyon. 2022 Aug 10;8(8):e10172. doi: 10.1016/j.heliyon.2022.e10172. eCollection 2022 Aug.
Estimate sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of EEG findings: centrotemporal spikes, photoparoxysmal response, asymmetric photic driving, and asymmetric sleep spindles, for epilepsy phenotype and presence of structural brain abnormalities.
In this case-control study we reviewed children referred for EEG over a 4-year period, with at least one of centrotemporal spikes, photoparoxysmal response, asymmetric photic driving, or asymmetric sleep spindles. This cohort was analyzed in combination with a research database of pediatric patients with seizures.
Centrotemporal spikes had 100% sensitivity for childhood epilepsy with centrotemporal spikes or atypical childhood epilepsy with centrotemporal spikes, but lower specificity (70%) and PPV (58%). Photoparoxysmal response had high specificity (92%) and NPV (92%) for genetic generalized epilepsy. Asymmetric photic driving had low sensitivity for structural brain abnormalities (17%), with specificity 80%. In contrast, asymmetric sleep spindles had much higher sensitivity and specificity, 44% and 97%, respectively.
Although centrotemporal spikes are classically associated with childhood epilepsy with centrotemporal spikes, these discharges are seen in other conditions. Photoparoxysmal response is highly indicative of a genetic generalized epilepsy, though may be seen in other epilepsy phenotypes. Relative attenuation of sleep spindles is a more reliable indicator of structural brain malformation than asymmetric photic driving.
The quantitative diagnostic utility of EEG findings should be considered when incorporating these results into clinical decision-making.
评估脑电图（EEG）检查结果（中央颞区棘波、光阵发性反应、不对称光驱动和不对称睡眠纺锤波）对于癫痫表型和脑结构异常存在情况的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。
在这项病例对照研究中，我们回顾了4年间接受EEG检查的儿童，这些儿童至少有中央颞区棘波、光阵发性反应、不对称光驱动或不对称睡眠纺锤波中的一项。该队列与一个癫痫患儿研究数据库相结合进行分析。
中央颞区棘波对于伴有中央颞区棘波的儿童癫痫或伴有中央颞区棘波的非典型儿童癫痫的敏感性为100%，但特异性较低（70%）和PPV较低（58%）。光阵发性反应对于遗传性全面性癫痫具有高特异性（92%）和NPV（92%）。不对称光驱动对脑结构异常的敏感性较低（17%），特异性为80%。相比之下，不对称睡眠纺锤波的敏感性和特异性要高得多，分别为44%和97%。
虽然中央颞区棘波传统上与伴有中央颞区棘波的儿童癫痫相关，但这些放电也可见于其他情况。光阵发性反应高度提示遗传性全面性癫痫，不过也可能见于其他癫痫表型。与不对称光驱动相比，睡眠纺锤波的相对减弱是脑结构畸形更可靠的指标。
在将这些结果纳入临床决策时，应考虑EEG检查结果的定量诊断效用。
