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脑电图联合神经元特异性烯醇化酶在小儿热性惊厥中的鉴别诊断价值及其对脑功能预后的预测价值

Differential diagnostic value of electroencephalogram combined with NSE in pediatric febrile seizures and its predictive value for brain function prognosis.

作者信息

Cao Jun, Xiao Xiangping, Li Shuhui

机构信息

Department of Pediatrics, The Second People's Hospital of Jingdezhen Jingdezhen 333000, Jiangxi, China.

Department of Nephrology, The Second People's Hospital of Jingdezhen Jingdezhen 333000, Jiangxi, China.

出版信息

Am J Transl Res. 2025 Mar 15;17(3):1892-1900. doi: 10.62347/YMVM3188. eCollection 2025.

Abstract

OBJECTIVE

To investigate the diagnostic value of electroencephalogram (EEG) combined with neuron-specific enolase (NSE) detection in differentiating febrile seizures and to evaluate their predictive value for brain function prognosis in pediatric patients.

METHODS

A retrospective analysis was performed on the medical records of 95 pediatric patients with febrile seizures treated at the Second People's Hospital of Jingdezhen City from January 2021 to December 2023. Of these, 40 cases of simple febrile seizure (SFS) patients were categorized into Group A, and 55 cases of complex febrile seizure (CFS) patients were included in Group B. Brainwave data was collected within 72 hours of the seizure, and NSE levels were measured at 12 and 48 hours post-seizure, as well as immediately after treatment. Venous blood (1-2 mL) was drawn and tested within 2 hours. The number and incidence of abnormal EEG findings, along with NSE levels, were recorded. The diagnostic value of EEG, NSE, and their combined application in febrile seizures, as well as their predictive value for brain function prognosis, were analyzed.

RESULTS

The incidence of abnormal EEG in Group B was notably higher than that in Group A (P=0.038). Additionally, the NSE level in Group B was consistently higher at all time points compared to Group A (all P<0.05). The area under the curve (AUC) for EEG, NSE, and their combined detection in differential diagnosis of febrile seizures was 0.600, 0.807, and 0.814, respectively. The specificity for these measures was 80.00%, 85.00%, and 75.00%, while the sensitivity was 40.00%, 72.73%, and 78.18%, respectively. The AUCs of EEG, NSE and their combined detection for predicting the prognosis of febrile seizures in children was 0.745, 0.878 and 0.951, with the specificity of 66.67%, 58.72% and 81.48%, and the sensitivity of 82.35%, 73.53% and 100.00%, respectively. Logistic multivariate analysis revealed that EEG findings, febrile seizure type, perinatal abnormalities, and NSE levels were independent risk factors affecting post-seizure sequelae in pediatric patients with febrile seizures.

CONCLUSION

The combination of EEG and NSE is valuable for the differential diagnosis of febrile seizures and offers strong predictive power for brain function prognosis. Their combined detection enhances diagnostic accuracy and offers substantial practical benefits.

摘要

目的

探讨脑电图(EEG)联合神经元特异性烯醇化酶(NSE)检测在鉴别热性惊厥中的诊断价值,并评估其对小儿患者脑功能预后的预测价值。

方法

对2021年1月至2023年12月在景德镇市第二人民医院治疗的95例小儿热性惊厥患者的病历进行回顾性分析。其中,40例单纯热性惊厥(SFS)患者归入A组,55例复杂性热性惊厥(CFS)患者纳入B组。在惊厥发作72小时内收集脑电波数据,并在惊厥发作后12小时、48小时以及治疗后立即测量NSE水平。在2小时内采集静脉血(1 - 2 mL)进行检测。记录EEG异常结果的数量和发生率以及NSE水平。分析EEG、NSE及其联合应用在热性惊厥中的诊断价值以及它们对脑功能预后的预测价值。

结果

B组EEG异常发生率显著高于A组(P = 0.038)。此外,B组在所有时间点的NSE水平均始终高于A组(所有P < 0.05)。EEG、NSE及其联合检测在热性惊厥鉴别诊断中的曲线下面积(AUC)分别为0.600、0.807和0.814。这些检测方法的特异性分别为80.00%、85.00%和75.00%,而敏感性分别为40.00%、72.73%和78.18%。EEG、NSE及其联合检测对小儿热性惊厥预后预测的AUC分别为0.745、0.878和0.951,特异性分别为66.67%、58.72%和81.48%,敏感性分别为82.35%、73.53%和100.00%。Logistic多因素分析显示,EEG结果、热性惊厥类型、围产期异常以及NSE水平是影响小儿热性惊厥发作后后遗症的独立危险因素。

结论

EEG与NSE联合应用对热性惊厥的鉴别诊断具有重要价值,对脑功能预后具有较强的预测能力。它们的联合检测提高了诊断准确性并具有显著的实际应用价值。

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