Diagnostische waarde EEG in relatie tot post ictaal interval

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1 Diagnostische waarde EEG in relatie tot post ictaal interval
CAT M. de Krom 10 november 2005

2 Diagnostische waarde EEG in relatie tot post ictaal interval
Sensitiviteit EEG*: 53% dag van insult 42% daarop volgende week 34% daarop volgende jaar (uitsluitend voor gegeneraliseerde insulten; voor andere aanvalsvormen/specifieke epilepsiesyndromen onvoldoende onderzocht) Ann Neurol Jun;17(6): Related Articles, Links Electroencephalographic spiking activity, drug levels, and seizure occurrence in epileptic patients. Gotman J, Marciani MG. We investigated the relationships among the electroencephalographic spiking rate, drug levels, and seizure occurrence in 44 patients with focal epilepsy. Seizure occurrence was continuously monitored by personnel or videorecording and spiking rate was quantified by an automatic detection method. Results indicate that drug levels do not influence spiking rate, and spiking rate does not change before seizures but increases markedly after them, particularly secondarily generalized seizures. This increase can last several days and is observed during wakefulness and sleep. High or low spiking rates do not influence the occurrence of seizures. We suggest that interictal spikes may passively reflect damage to the brain, a damage which is worsened by further seizures. Spikes may not be directly related to seizure generation. Acta Neurol Scand May;87(5): Related Articles, Links Occurrence of epileptiform activity in the routine EEG of epileptic patients. Doppelbauer A, Zeitlhofer J, Zifko U, Baumgartner C, Mayr N, Deecke L. Neurology Clinic, University of Vienna, Austria. In a retrospective study, the occurrence of epileptiform activity (EA) in routine EEG records of epileptic patients was investigated. Data were obtained from 1078 EEGs of 373 patients (199 men and 174 women; aged (mean /-14.7)). The percentage of 38% of patients with EA in a single EEG could be increased to 77% by repeated records. After the 5th record however, the gain in new information decreased remarkably. No differences between seizure types could be detected. There was a relationship between EA and nonspecific EEG abnormalities. High EA rates were found for short time intervals since last seizure, young patients, long durations of the seizure disorder and for high seizure frequencies. *Gotman en Marciani,1985; Doppelbauer et al., 1993

3 Sensitiviteit EEG 30 minuten waak EEG registratie: bij niet meer dan 30% van alle epilepsie patiënten in alle EEG's epileptiforme verschijnselen (Ajmone Marsan en Zivin, 1970) Herhaalde EEG’s vergroten sensitiviteit: 38% na het 1e EEG 49% na het 2e EEG 66% na het 4e EEG 77% na het 6e EEG (Doppelbauer et al., 1993) 82,5% na 10 of meer EEG's (Ajmone Marsan en Zivin, 1970). Bij ruim 15% epilepsie patiënten waak EEG's consistent niet afwijkend

4 Sensitiviteit EEG Leeftijd is van belang: hoe jonger de patiënt, des te groter de sensitiviteit 52% in de 2e decade 39% in de 3e decade en 28% in de 6e decade (Doppelbauer et al., 1993)