Zafar Azra, Aljaafari Danah, Shariff Erum, Shahid Rizwana, Alkhaldi Norah A, Nazish Saima, Alshurem Mohammed, AlAmri Abdullah Saleh, AlShamrani Foziah Jabbar Gossab
Department of Neurology, College of Medicine, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Dammam, 34212, Kingdom of Saudi Arabia.
Neurol Sci. 2025 Jun;46(6):2789-2800. doi: 10.1007/s10072-025-08095-w. Epub 2025 Mar 15.
Periodic discharges (PDs) in critically ill patients with altered mental status (CIPAMS) have important implications. This study aimed to describe different characteristics of PDs in CIPAMS using routine electroencephalogram.
This retrospective study was carried out at King Fahd University Hospital. The EEG recordings of CIPAMS reporting PDs were reviewed. All patients had at least 30 min of portable EEG recording (pEEG). Patients were dichotomized into two groups according to PDs. Clinical and radiological variables between the two groups were compared using Chi-square tests and Odds ratio. P value < 0.05 was considered statistically significant.
The electronic charts of 295 consecutive CIPAMS were reviewed. PDs, detected in 21% of the patients, were significantly more frequent in women as compared to men (OR = 1.71,CI = 1.09-2.67,P = 0.01). The mean (SD) age of the patients was significantly higher in the group having PDs than without (P = 0.01). LPDs were detected in 41, and GPDs in 17 patients. Chronic neurological illness, encephalitis, and brain tumor had a significant association with LPDs, whereas metabolic derangement and Creutzfeldt-Jakob disease with GPDs. The frequency and peri-ictal features were important determinants of non-convulsive seizure (NCS). Overall, PDs were associated with an increased likelihood of unfavorable outcomes and mortality.
意识状态改变的重症患者（CIPAMS）中的周期性放电（PDs）具有重要意义。本研究旨在使用常规脑电图描述CIPAMS中PDs的不同特征。
这项回顾性研究在法赫德国王大学医院进行。对报告有PDs的CIPAMS患者的脑电图记录进行了回顾。所有患者均有至少30分钟的便携式脑电图记录（pEEG）。根据PDs将患者分为两组。使用卡方检验和比值比比较两组之间的临床和放射学变量。P值<0.05被认为具有统计学意义。
回顾了295例连续CIPAMS患者的电子病历。在21%的患者中检测到PDs，女性患者中的PDs明显比男性更频繁（OR = 1.71，CI = 1.09 - 2.67，P = 0.01）。有PDs的患者组的平均（标准差）年龄明显高于无PDs的患者组（P = 0.01）。在41例患者中检测到长程周期性放电（LPDs），17例患者中检测到广义周期性放电（GPDs）。慢性神经疾病、脑炎和脑肿瘤与LPDs有显著关联，而代谢紊乱和克雅氏病与GPDs有显著关联。频率和发作期特征是非惊厥性癫痫（NCS）的重要决定因素。总体而言，PDs与不良结局和死亡率增加的可能性相关。
