Characteristics of overnight video-EEG monitoring in infantile epileptic spasms syndrome at 2-week follow-up.

IF 6.6 1区 医学 Q1 CLINICAL NEUROLOGY Epilepsia Pub Date : 2024-10-15 DOI:10.1111/epi.18143
Akshat Katyayan, Steven T Lee, Luis Martinez, Danielle S Takacs
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Abstract

Objective: To determine the optimal duration of electroencephalography (EEG) recording to detect epileptic spasms (ES) based on inpatient overnight video-EEG monitoring in patients with infantile epileptic spasms syndrome (IESS) at the 2-week follow-up.

Methods: Patients with IESS and overnight EEG monitoring between January 2020 and June 2022 were retrospectively reviewed. Time-to-ES, time-to-sleep and time-to-epileptic encephalopathy (EE) per the Burden of Amplitudes and Epileptiform Discharges (BASED 2021) score. BASED 2021 score were reported. ES and sleep detection sensitivity were calculated with respect to monitoring time. Etiology, treatment, and EEG features were assessed for strength of association with continued ES. Time-to-event analysis was performed with the first ES as the event of interest.

Results: Of 90 patients, 39 (43%) continued to have ES; 78.6% with EE continued to have ES, whereas only 27.4% without EE had ES (odds ratio [OR] 12.05). Structural etiologies were also associated with continued ES (OR 5.24). ES detection was 35.9%, 76.9%, and 84.6% at 1, 4, and 6 h, respectively, with corresponding negative likelihood ratios (NLRs) of .64, .23, and .15. ES detection reached >90% and >95% at 14 and 19 h, respectively. Sleep detection was 52.2%, 84.4%, and 95.6% at 1, 4, and 6 h, respectively, and captured in all patients by 11 h. EE was observed by 6 h for all associated patients.

Significance: Typical routine EEG durations (<1 h) were not sufficient to detect ES, EE, or sleep in patients with IESS at the 2-week follow-up. Four hour outpatient EEG will capture ES in 77% and sleep in 84% of the patients. EE, if present, was shortly after sleep onset. Additional monitoring of up to 19 h was needed to capture >95% of patients with ES. Although EE was strongly associated with continued ES, 27.4% of patients without EE demonstrated ES. This study will help guide adequate duration of EEG monitoring at the 2-week follow-up for patients with IESS.

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婴儿癫痫痉挛综合征患者在两周随访期间的夜间视频脑电图监测特征。
目的根据对婴儿癫痫痉挛综合征(IESS)患者住院2周随访时的隔夜视频脑电图监测结果,确定检测癫痫痉挛(ES)的最佳脑电图记录时间:方法:对 2020 年 1 月至 2022 年 6 月期间接受过通宵脑电图监测的 IESS 患者进行回顾性研究。根据振幅和痫样放电负担(BASED 2021)评分,报告了发生 IESS 的时间、发生睡眠的时间和发生癫痫性脑病(EE)的时间。报告了 BASED 2021 评分。根据监测时间计算 ES 和睡眠检测灵敏度。评估了病因、治疗和脑电图特征与持续 ES 的关联强度。以首次 ES 为关注事件,进行时间到事件分析:在 90 名患者中,39 人(43%)继续患有 ES;78.6% 的 EE 患者继续患有 ES,而只有 27.4% 的无 EE 患者患有 ES(几率比 [OR] 12.05)。结构性病因也与 ES 持续存在有关(OR 5.24)。1 小时、4 小时和 6 小时的 ES 检出率分别为 35.9%、76.9% 和 84.6%,相应的负似然比 (NLR) 分别为 0.64、0.23 和 0.15。ES 检测率在 14 和 19 h 分别达到 >90% 和 >95%。睡眠检测率在 1、4 和 6 h 时分别为 52.2%、84.4% 和 95.6%,所有患者在 11 h 前均能检测到睡眠:典型的常规脑电图持续时间(95% 的 ES 患者在 1 小时、4 小时和 6 小时内出现 EE)。虽然 EE 与持续 ES 密切相关,但 27.4% 的无 EE 患者表现出 ES。这项研究将有助于指导 IESS 患者在 2 周随访时进行适当的脑电图监测。
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来源期刊
Epilepsia
Epilepsia 医学-临床神经学
CiteScore
10.90
自引率
10.70%
发文量
319
审稿时长
2-4 weeks
期刊介绍: Epilepsia is the leading, authoritative source for innovative clinical and basic science research for all aspects of epilepsy and seizures. In addition, Epilepsia publishes critical reviews, opinion pieces, and guidelines that foster understanding and aim to improve the diagnosis and treatment of people with seizures and epilepsy.
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