摘要
目的评估急性脑损伤(ABI)患者脑电图癫痫样异常(EA)与随后癫痫发展的关系。方法选取2021年1月至2022年6月于北京大望路急诊抢救医院治疗的101例ABI患者作为研究对象,其中男性63例,女性38例,年龄(56.3±6.8)岁。根据住院期间连续脑电图(cEEG)监测结果,将患者分为EA组(n=31)和无EA组(n=70)。出院后随访1年,观察两组患者自发临床癫痫发作的发生,以及癫痫发展的时间和抗癫痫药物的使用情况。结果EA患者随访期间发生癫痫比例明显高于无EA患者(41.9%vs.18.6%,P=0.026)。与无EA患者相比,EA患者在随访期间更有可能继续进行抗癫痫药物治疗。使用多变量Cox回归分析,在调整了年龄、性别、cEEG癫痫发作、ABI病因和出院时抗癫痫药物治疗后,与无EA患者相比,EA患者发生癫痫的风险增加3倍以上(HR:3.39,95%CI:1.39~8.27,P=0.008)。结论ABI患者cEEG上出现EA与新发癫痫风险增加3倍以上有关,cEEG可作为评估癫痫发作长期风险的有用工具。
Objective To evaluate the relationship between EEG epileptoid abnormalities(EA)and subsequent development of epilepsy in patients with acute brain injury(ABI).Methods A total of 101 ABI patients treated in Beijing Dawanglu Emergency Rescue Hospital from January 2021 to June 2022 were collected as the study objects,including 63 males and 38 females,aged(56.3±6.8)years.Patients were divided into EA group(n=31)and no EA group(n=70)based on continuous electroencephalogram(cEEG)monitoring results during hospitalization.After discharge,patients were followed up for 1 year to observe the occurrence of spontaneous clinical seizures,as well as the time of epilepsy development and the use of antiepileptic drugs in both groups.Results The proportion of patients with EA who developed epilepsy during follow-up was significantly higher than those without EA(41.9%vs.18.6%,P=0.026).Compared with patients without EA,patients with EA were more likely to continue antiepileptic medication during the follow-up period.Using multivariate Cox regression analysis,after adjusting for age,sex,cEEG seizure onset,ABI etiology,and antiepileptic medication at discharge,patients with EA had a more than three-fold increased risk of developing epilepsy compared with patients without EA(HR:3.39,95%CI:1.39-8.27,P=0.008).Conclusion The presence of EA on cEEG in ABI patients is associated with a more than 3-fold increased risk of new seizures,and cEEG can be a useful tool for assessing the long-term risk of seizures.
作者
张守文
Zhang Shouwen(Department of Neuroelectrophysiology,Beijing Dawanglu Emergency Rescue Hospital,Beijing City,100122,China)
出处
《现代电生理学杂志》
2024年第3期134-137,共4页
Journal of Modern Electrophysiology
关键词
脑损伤
癫痫
脑电描记术
Brain injuries
Epilepsy
Electroencephalography
