دورية أكاديمية
Brief potentially ictal rhythmic discharges and paroxysmal fast activity as scalp electroencephalographic biomarkers of seizure activity and seizure onset zone.
| العنوان: | Brief potentially ictal rhythmic discharges and paroxysmal fast activity as scalp electroencephalographic biomarkers of seizure activity and seizure onset zone. |
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| المؤلفون: | Yoo JY; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA., Jetté N; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA., Kwon CS; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA., Young J; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA., Marcuse LV; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA., Fields MC; Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA., Gaspard N; Department of Neurology, Yale University, New Haven, Connecticut, USA.; Department of Neurology, Free University of Brussels-Erasmus Hospital, Brussels, Belgium., Hirsch LJ; Department of Neurology, Yale University, New Haven, Connecticut, USA. |
| المصدر: | Epilepsia [Epilepsia] 2021 Mar; Vol. 62 (3), pp. 742-751. Date of Electronic Publication: 2021 Feb 12. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Blackwell Science Country of Publication: United States NLM ID: 2983306R Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1528-1167 (Electronic) Linking ISSN: 00139580 NLM ISO Abbreviation: Epilepsia Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Malden, MA : Blackwell Science Original Publication: Copenhagen : Munskgaard |
| مواضيع طبية MeSH: | Electroencephalography*, Seizures/*physiopathology, Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biomarkers ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Seizures/diagnosis ; Young Adult |
| مستخلص: | Objective: The electroencephalographic (EEG) terms "brief potentially ictal rhythmic discharges" (BIRDs) and "paroxysmal fast activity" (PFA) are considered distinct entities; however, their definitions overlap, and they may have similar clinical significance. We investigated their clinical significance and their association with seizures and the seizure onset zone (SOZ). Methods: We retrospectively identified an adult cohort (July 2015 to March 2018) whose long-term (>12 h) EEGs in any setting reported BIRDs (>4 Hz, lasting .5-10 s) and/or PFA. Different frequency cutoffs for PFA (>13 Hz or ≥8 Hz) were tested to compare their clinical significance. Patient demographics, clinical history, and EEG features were recorded. Results: We identified 94 patients with BIRDs/PFA out of 3520 patients (3%); 36 were critically ill (12 with epilepsy), and 58 were noncritically ill (all with epilepsy). The frequency of BIRDs/PFA was largely dependent on EEG background: it tended to be slower (theta) in the absence of a posterior dominant rhythm or in the presence of continuous focal slowing in the same region (p = .01). Sixty-two of 94 patients (66%; 32/36 [89%] critically ill, 30/58 [52%] noncritically ill) had electrographic seizures during the recording. The scalp EEG SOZ colocalized with BIRDs/PFA in all cases. BIRDs with faster frequency (also qualifying as PFA by definition) had similar seizure risk to that of slower BIRDs (62%-71%), regardless of frequency cutoff used to define PFA. In addition, 30 of 30 (100%) patients with evolving BIRDs/PFA (which lasted a median of 6 s, range = 2-9.5 s) had electrographic seizures (>10 s), compared to 32 of 64 (50%) with nonevolving BIRDs (median = 1 s, range = .5-3.5 s; p < .01). Significance: A high proportion of patients with BIRDs/PFA had seizures on EEG, regardless of their frequency (i.e., whether they also qualified as PFA), and their location colocalized with scalp SOZ in all cases. BIRDs appear to be a scalp EEG biomarker of uncontrolled seizure activity and a reliable localizing sign of the SOZ. (© 2021 International League Against Epilepsy.) |
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| فهرسة مساهمة: | Keywords: critical care; drug-resistant epilepsy; electroencephalography; intensive care unit EEG monitoring; nonconvulsive seizures |
| المشرفين على المادة: | 0 (Biomarkers) |
| تواريخ الأحداث: | Date Created: 20210212 Date Completed: 20210921 Latest Revision: 20210921 |
| رمز التحديث: | 20240628 |
| DOI: | 10.1111/epi.16822 |
| PMID: | 33576500 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1528-1167 |
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| DOI: | 10.1111/epi.16822 |