Garrido Elena, Adeli Amir, Echeverria-Villalobos Marco, Fiorda Juan, Hannawi Yousef
Department of Anesthesiology, The University of Iowa Carver College of Medicine, Iowa City, USA.
Department of Neurology, Division of Epilepsy, The Ohio State University Wexner Medical Center, Columbus, USA.
Cureus. 2024 Mar 10;16(3):e55903. doi: 10.7759/cureus.55903. eCollection 2024 Mar.
The objective of this study is to evaluate the prevalence of electrographic seizures in hospitalized patients with altered mental status and no significant risk factors for seizures.
We retrospectively reviewed over a six-year period (2013-2019) the medical records of all adults admitted at Ohio State University Wexner Medical Center (OSUWMC), who underwent continuous electroencephalography (cEEG) monitoring for > 48 hours. Our primary objective was to identify the prevalence of electrographic seizures in patients with altered mental status and no significant acute or remote risk factors for seizures.
A total of 1966 patients were screened for the study, 1892 were excluded (96.2%) and 74 patients met inclusion criteria. Electrographic seizures were identified in seven of 74 patients (9.45%). We found a significant correlation between electrographic seizures and a history of hepatic cirrhosis, n= 4 (57%), (p=0.035), acute chronic hepatic failure during admission, 71% (n=5), (p=0.027), and hyperammonemia (p =0.009).
In this retrospective study of patients with altered mental status and no significant acute or remote risk factors for seizures who underwent cEEG monitoring for > 48 hours, electrographic seizures were identified in 9.45%. Electrographic seizures were associated with hepatic dysfunction and hyperammonemia. Based on our results, cEEG monitoring should be considered in patients with altered mental status and hepatic dysfunction even in the absence of other seizure risk factors.
本研究的目的是评估精神状态改变且无明显癫痫发作危险因素的住院患者中脑电图癫痫发作的患病率。
我们回顾性分析了俄亥俄州立大学韦克斯纳医学中心（OSUWMC）在六年期间（2013 - 2019年）所有接受持续脑电图（cEEG）监测超过48小时的成年患者的病历。我们的主要目的是确定精神状态改变且无明显急性或既往癫痫发作危险因素的患者中脑电图癫痫发作的患病率。
共有1966名患者被纳入本研究筛查，1892名被排除（96.2%），74名患者符合纳入标准。74名患者中有7名（9.45%）被确定有脑电图癫痫发作。我们发现脑电图癫痫发作与肝硬化病史（n = 4，57%，p = 0.035）、入院期间急性慢性肝衰竭（71%，n = 5，p = 0.027）和高氨血症（p = 0.009）之间存在显著相关性。
在这项对精神状态改变且无明显急性或既往癫痫发作危险因素并接受超过48小时cEEG监测的患者的回顾性研究中，9.45%的患者被确定有脑电图癫痫发作。脑电图癫痫发作与肝功能障碍和高氨血症相关。根据我们的结果，即使在没有其他癫痫发作危险因素的情况下，对于精神状态改变和肝功能障碍的患者也应考虑进行cEEG监测。
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