Moussalli-Salefranque F, Mises J, Plouin P
Rev Electroencephalogr Neurophysiol Clin. 1983 Dec;13(3):240-4. doi: 10.1016/s0370-4475(83)80034-3.
This article is devoted to a consideration of the clinical prognostic significance of "tracé discontinu". The authors first distinguish "tracé discontinu" from the "tracé paroxystique" and tracé alternant" patterns in the newborn. The distinction is very important. The bad prognosis of the "tracé paroxystique" is well known, but prognosis of the "tracé discontinu" seems to be different. If the "tracé discontinu" is permanent, there was a 50% favourable outcome in our 22 newborn babies brought to the reanimation department. If some continuous activity can be observed: beginning of sleep organisation, then the prognosis seems to be better: 61% of our cases. As blood levels of anticonvulsants are rarely measured it seems difficult, given our present knowledge, to appreciate anticonvulsive drug effects on EEG recordings. Thus 3 aims should be pointed out: --Measurements of anticonvulsant blood level each time a "tracé discontinu" is observed in a treated newborn. --Early EEG recordings of sufficient duration to obtain eventually some continuous tracing. --Correct differentiation between "tracé paroxystique" and "tracé discontinu" for the clinician: "tracé discontinu" in a full-term newborn should never allow the paediatrician to stop treatment.
本文致力于探讨“不连续描记”的临床预后意义。作者首先将新生儿中的“不连续描记”与“阵发描记”和“交替描记”模式区分开来。这种区分非常重要。“阵发描记”的不良预后是众所周知的,但“不连续描记”的预后似乎有所不同。如果“不连续描记”是永久性的,在我们送往复苏科的22例新生儿中,有50%的预后良好。如果能观察到一些连续活动:睡眠开始有组织化,那么预后似乎更好:我们的病例中有61%。由于很少测量抗惊厥药物的血药浓度,就我们目前的知识而言,似乎很难评估抗惊厥药物对脑电图记录的影响。因此,应指出三个目标:——每次在接受治疗的新生儿中观察到“不连续描记”时,测量抗惊厥药物的血药浓度。——进行足够时长的早期脑电图记录,最终获得一些连续的描记。——临床医生要正确区分“阵发描记”和“不连续描记”:足月新生儿出现“不连续描记”时,儿科医生绝不能因此停止治疗。