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Automated quantification of spike-wave activity may be used to predict the development of Electrical Status Epilepticus in Sleep (ESES) in children with perinatal stroke
Clinical Neurophysiology ( IF 4.7 ) Pub Date : 2021-01-01 , DOI: 10.1016/j.clinph.2020.11.003
Abdullah Azeem 1 , Adam Kirton 2 , Juan Pablo Appendino 2 , Silvia Kozlik 3 , Aleksandra Mineyko 2
Affiliation  

OBJECTIVE Continuous spike and wave in slow-wave sleep (CSWS), an epileptic encephalopathy, occurs after perinatal stroke where it is associated with cognitive decline. CSWS features a distinct EEG pattern, electrical status epilepticus in sleep (ESES). Biomarkers for the prediction of ESES have not been identified but will facilitate earlier diagnosis and treatment. We hypothesized that spike-frequency and differences in power spectra would be predictive of subsequent ESES. METHODS A cross-sectional study comparing EEG spike-frequency and Power before the development of ESES in patients with perinatal stroke, patients with focal epilepsy, and appropriate controls. RESULTS 43 patients met the inclusion criteria; 11 stroke-ESES, 10 stroke controls, 14 epilepsy-ESES, 8 epilepsy controls. ESES patients had higher pre-diagnosis mean spike-frequency (24.0 ± 24 versus 6.6 ± 9.1 SW/min, p = 0.002) than patients that did not develop ESES; these differences present ~ 3 years before ESES diagnosis. Pre-diagnosis, normalized delta power (1-4 Hz) was higher in the stroke-ESES group (105.7 ± 58 dB/Hz) compared to stroke controls (57.4 ± 45 dB/Hz, p = 0.036). CONCLUSION Spike-frequency and delta power may represent EEG biomarkers of the risk of developing ESES in children with perinatal stroke. SIGNIFICANCE EEG biomarkers may be used by clinicians to assess which patients are more at-risk for ESES. Using spike-frequency, clinicians may be able to identify patients at risk of developing ESES.

中文翻译:

棘波活动的自动量化可用于预测围产期卒中儿童睡眠中癫痫持续电状态 (ESES) 的发展

目的 慢波睡眠 (CSWS) 中的连续峰值和波是一种癫痫性脑病,发生在围产期卒中后,与认知能力下降有关。CSWS 具有独特的 EEG 模式,即睡眠中癫痫持续状态 (ESES)。用于预测 ESES 的生物标志物尚未确定,但将有助于早期诊断和治疗。我们假设尖峰频率和功率谱的差异可以预测随后的 ESES。方法 一项横断面研究,比较围产期卒中患者、局灶性癫痫患者和适当对照的 ESES 发生前的 EEG 尖峰频率和功率。结果 符合纳入标准43例;11 个中风-ESES,10 个中风对照,14 个癫痫-ESES,8 个癫痫对照。ESES 患者比未发生 ESES 的患者具有更高的诊断前平均峰值频率(24.0 ± 24 对 6.6 ± 9.1 SW/min,p = 0.002);这些差异在 ESES 诊断前约 3 年出现。与中风对照组 (57.4 ± 45 dB/Hz, p = 0.036) 相比,中风 ESES 组的诊断前归一化 delta 功率 (1-4 Hz) (105.7 ± 58 dB/Hz) 更高。结论 峰值频率和 delta 功率可能代表围产期卒中儿童发生 ESES 风险的 EEG 生物标志物。意义 临床医生可以使用脑电图生物标志物来评估哪些患者更容易发生 ESES。使用尖峰频率,临床医生可能能够识别有发生 ESES 风险的患者。与中风对照组 (57.4 ± 45 dB/Hz, p = 0.036) 相比,中风 ESES 组的诊断前归一化 delta 功率 (1-4 Hz) (105.7 ± 58 dB/Hz) 更高。结论 峰值频率和 delta 功率可能代表围产期卒中儿童发生 ESES 风险的 EEG 生物标志物。意义 临床医生可以使用脑电图生物标志物来评估哪些患者更容易发生 ESES。使用尖峰频率,临床医生可能能够识别有发生 ESES 风险的患者。与中风对照组 (57.4 ± 45 dB/Hz, p = 0.036) 相比,中风 ESES 组的诊断前归一化 delta 功率 (1-4 Hz) (105.7 ± 58 dB/Hz) 更高。结论 峰值频率和 delta 功率可能代表围产期卒中儿童发生 ESES 风险的 EEG 生物标志物。意义 临床医生可以使用脑电图生物标志物来评估哪些患者更容易发生 ESES。使用尖峰频率,临床医生可能能够识别有发生 ESES 风险的患者。意义 临床医生可以使用脑电图生物标志物来评估哪些患者更容易发生 ESES。使用尖峰频率,临床医生可能能够识别有发生 ESES 风险的患者。意义 临床医生可以使用脑电图生物标志物来评估哪些患者更容易发生 ESES。使用尖峰频率,临床医生可能能够识别有发生 ESES 风险的患者。
更新日期:2021-01-01
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