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卡尔加里评分和改良卡尔加里评分在儿童晕厥与遗传性全面性癫痫发作的鉴别诊断中的应用。

Calgary score and modified calgary score in the differential diagnosis between syncope and genetic generalized epilepsy in children.

机构信息

Department of Pediatrics, University of Health Science, Kartal Dr. Lutfi Kirdar City Hospital, Şemsi Denizer Cad. E-5 Karayolu Cevizli Mevkii, Kartal, 34890, Istanbul, Turkey.

Department of Pediatric Neurology, University of Health Science, Kartal Dr. Lutfi Kirdar City Hospital, Istanbul, Turkey.

出版信息

Sci Rep. 2023 Jul 31;13(1):12376. doi: 10.1038/s41598-023-39338-5.

Abstract

The purpose of the study is to explore the use of Calgary scoring (CS) and Modified Calgary scoring (MCS) in the differentiation of genetic generalized epilepsy and syncope in children. The study involved 117 patients aged < 18 years who presented to our hospital's pediatric neurology outpatient clinic with TLOC between June 2020 and June 2022. In addition to CS and MCS scoring, all patients were subjected to statistical analysis based on their age, sex, number of episodes and distribution during the day, duration of syncope, and family history. Seventy-one patients with syncope and 46 with epilepsy were included in the study. At a CS value >  - 1, sensitivity was 86.9% and specificity 63.4%, while at an MCS value >  - 1, sensitivity was 76.1% and specificity 71.8%. CS had less specificity and sensitivity in predicting epilepsy when focal epilepsies were excluded. Abnormal behavior noted by bystanders, including witnessed unresponsive, unusual posturing, or limb jerking? (Q5) emerged as the most important question for the detection of epilepsy. Compared with other syncope findings, loss of consciousness during prolonged sitting or standing (Q9) emerged as the most important for the detection of syncope.

摘要

本研究旨在探讨 Calgary 评分(CS)和改良 Calgary 评分(MCS)在儿童遗传性全面性癫痫和晕厥中的鉴别诊断中的应用。研究纳入了 2020 年 6 月至 2022 年 6 月期间因 TLOC 就诊于我院儿科神经科门诊的 117 例年龄<18 岁的患者。除 CS 和 MCS 评分外,所有患者还根据年龄、性别、发作次数和日间分布、晕厥持续时间以及家族史进行了统计分析。研究纳入了 71 例晕厥患者和 46 例癫痫患者。CS 值> -1 时,敏感性为 86.9%,特异性为 63.4%,而 MCS 值> -1 时,敏感性为 76.1%,特异性为 71.8%。排除局灶性癫痫后,CS 在预测癫痫方面的特异性和敏感性较低。旁观者注意到的异常行为,包括观察到无反应、异常姿势或肢体抽搐?(Q5)是检测癫痫的最重要问题。与其他晕厥表现相比,长时间坐立或站立时意识丧失(Q9)是检测晕厥的最重要表现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ec0/10390527/7e776f7cc1b6/41598_2023_39338_Fig1_HTML.jpg

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