背景婴儿癫痫性痉挛综合征(infantile epileptic spasms syndrome,IESS)预后较差。目前的治疗强调早期控制痉挛发作以及脑电图改善。振幅负荷和癫痫样放电(burden of amplitudes and epileptiform discharges,BASED)评分是一种用于评估I...背景婴儿癫痫性痉挛综合征(infantile epileptic spasms syndrome,IESS)预后较差。目前的治疗强调早期控制痉挛发作以及脑电图改善。振幅负荷和癫痫样放电(burden of amplitudes and epileptiform discharges,BASED)评分是一种用于评估IESS患儿脑电图严重程度的量化方式,但目前为止未在国内推广应用。目的评估脑电图工作人员使用BASED评分方法对IESS患儿脑电图结果进行判读的一致性,探讨其在国内应用的可能性。方法选取2022年7月—2023年6月在解放军总医院第一医学中心儿科就诊的IESS患儿脑电图数据。随机选择30份初始评价分值为2~5分的脑电图,经由来自5个不同研究中心的6名脑电图工作人员依据BASED评分规则进行评分。使用Fleiss'Kappa检验统计所有脑电图工作人员在评价时间段和评分分值上的一致性,并进一步分为不同工作年限(高年资:全职从事脑电图专业≥10年;低年资:全职从事脑电图专业>5~<10年),统计上述一致性。结果所有6名脑电图工作人员在评分时间段的选择上一致性较高(Kappa=0.623,P<0.001),高年资组在评分时间段的选择上一致性一般(Kappa=0.544,P<0.001),两低年资组一致性较高(Kappa=0.655,P<0.001)。所有6名脑电图工作人员在具体的BASED评分上一致性较低(Kappa=0.361,P<0.001),高年资组在BASED评分上一致性一般(Kappa=0.420,P<0.001),低年资组在BASED评分上一致性较低(Kappa=0.237,P<0.001)。进一步的结果显示,无论是全部6名评价者之间还是不同年资组内,对于BASED评分为5分的样本表现出更高的一致性,Kappa值分别为0.693、0.772、0.686。结论BASED评分用于IESS评价在我国仍面临挑战,脑电图工作人员间判读结果的不一致性限制了其广泛应用。展开更多
Children undergoing surgery with infant-onset epilepsy were classified into t hose with medically refractory infantile spasms(IS), successfully treated IS, an d no IS history, and the groups were compared for pre-and ...Children undergoing surgery with infant-onset epilepsy were classified into t hose with medically refractory infantile spasms(IS), successfully treated IS, an d no IS history, and the groups were compared for pre-and postsurgery clinical and Vineland Ad aptive Behavior Scale (VABS) developmental quotients(DQ). Children without an IS history were older at surgery and had longer epilepsy durations than those with IS despite similar substrates, surgeries, and seizure frequencies. In all group s, better postsurgery VABS-DQ scores were associated with early surgical interv ention indicating that infant-onset epilepsy patients with or without IS are at risk for seizure-induced encephalopathy.展开更多
文摘背景婴儿癫痫性痉挛综合征(infantile epileptic spasms syndrome,IESS)预后较差。目前的治疗强调早期控制痉挛发作以及脑电图改善。振幅负荷和癫痫样放电(burden of amplitudes and epileptiform discharges,BASED)评分是一种用于评估IESS患儿脑电图严重程度的量化方式,但目前为止未在国内推广应用。目的评估脑电图工作人员使用BASED评分方法对IESS患儿脑电图结果进行判读的一致性,探讨其在国内应用的可能性。方法选取2022年7月—2023年6月在解放军总医院第一医学中心儿科就诊的IESS患儿脑电图数据。随机选择30份初始评价分值为2~5分的脑电图,经由来自5个不同研究中心的6名脑电图工作人员依据BASED评分规则进行评分。使用Fleiss'Kappa检验统计所有脑电图工作人员在评价时间段和评分分值上的一致性,并进一步分为不同工作年限(高年资:全职从事脑电图专业≥10年;低年资:全职从事脑电图专业>5~<10年),统计上述一致性。结果所有6名脑电图工作人员在评分时间段的选择上一致性较高(Kappa=0.623,P<0.001),高年资组在评分时间段的选择上一致性一般(Kappa=0.544,P<0.001),两低年资组一致性较高(Kappa=0.655,P<0.001)。所有6名脑电图工作人员在具体的BASED评分上一致性较低(Kappa=0.361,P<0.001),高年资组在BASED评分上一致性一般(Kappa=0.420,P<0.001),低年资组在BASED评分上一致性较低(Kappa=0.237,P<0.001)。进一步的结果显示,无论是全部6名评价者之间还是不同年资组内,对于BASED评分为5分的样本表现出更高的一致性,Kappa值分别为0.693、0.772、0.686。结论BASED评分用于IESS评价在我国仍面临挑战,脑电图工作人员间判读结果的不一致性限制了其广泛应用。
文摘Children undergoing surgery with infant-onset epilepsy were classified into t hose with medically refractory infantile spasms(IS), successfully treated IS, an d no IS history, and the groups were compared for pre-and postsurgery clinical and Vineland Ad aptive Behavior Scale (VABS) developmental quotients(DQ). Children without an IS history were older at surgery and had longer epilepsy durations than those with IS despite similar substrates, surgeries, and seizure frequencies. In all group s, better postsurgery VABS-DQ scores were associated with early surgical interv ention indicating that infant-onset epilepsy patients with or without IS are at risk for seizure-induced encephalopathy.
