Background: 

The aim of this observational study was to determine whether bilateral bispectral index (BIS) monitoring can detect seizures in epileptic patients.

Methods: 

Four-channel frontal BIS monitoring and standard 40-channel electroencephalography monitoring were conducted in epileptic patients undergoing evaluation for epilepsy surgery. The BIS numerical value, signal quality index, electromyography, suppression ratio, and color density spectral array were continuously recorded. In patients with electroencephalography-confirmed seizures, the mean value and trend (slope of linear regression) of bilateral BIS monitor parameters were analyzed from 1 minute before to 1 minute after seizure onset.

Results: 

Of 48 patients included in the study, 21 (43.8%) had at least 1 seizure. BIS numerical value was not able to detect focal or focal to bilateral tonic-clonic seizures. Considering all seizures, the only significant differences between recordings 1 minute before and 1 minute after seizure onset were a decrease in the signal quality index slope from 1 hemisphere (0.039±0.297 vs. −0.085±0.321, respectively; P=0.029) and in the mean signal quality index recorded from both hemispheres (left hemisphere: 65.775±30.599 vs. 61.032±26.285; P=0.016 and right hemisphere: 63.244±31.985 vs. 59.837±27.360; 0.029); these differences were not maintained after Hochberg adjustment for multiple comparisons. In seizures occurring during sleep, there was a change in the electromyography slope of 1 hemisphere before and after seizure onset (−0.141±0.176 vs. 0.162±0.140, respectively; P=0.038). There were variable responses in BIS parameters in the 3 patients who developed focal nonconvulsive seizure clusters.

Conclusion: 

Bilateral BIS monitoring was not able to detect the occurrence of seizures in epileptic patients.

中文翻译：

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双侧双频指数监测在非麻醉癫痫患者癫痫发作检测中的表现：一项观察性研究

背景： 

这项观察性研究的目的是确定双边双频指数 (BIS) 监测是否可以检测癫痫患者的癫痫发作。

方法： 

对接受癫痫手术评估的癫痫患者进行四通道额叶 BIS 监测和标准 40 通道脑电图监测。连续记录BIS数值、信号质量指标、肌电图、抑制比和色密度谱阵列。在脑电图证实的癫痫发作患者中，从癫痫发作前 1 分钟到发作后 1 分钟，分析双侧 BIS 监测参数的平均值和趋势（线性回归的斜率）。

结果： 

在纳入研究的 48 名患者中，21 名（43.8%）至少有 1 次癫痫发作。BIS 数值无法检测局灶性或局灶性至双侧强直阵挛发作。考虑到所有癫痫发作，癫痫发作前 1 分钟和癫痫发作后 1 分钟的记录之间的唯一显着差异是信号质量指数斜率从 1 个半球下降（分别为 0.039±0.297 对 -0.085±0.321；P = 0.029）和从两个半球记录的平均信号质量指数（左半球：65.775±30.599 vs. 61.032±26.285；P= 0.016 和右半球：63.244±31.985 vs. 59.837±27.360；0.029); 在对多重比较进行 Hochberg 调整后，这些差异并未保持。在睡眠期间发生的癫痫发作中，癫痫发作前后1个半球的肌电图斜率发生变化（分别为-0.141±0.176 vs. 0.162±0.140；P = 0.038）。在 3 名发生局灶性非惊厥性癫痫发作的患者中，BIS 参数的反应各不相同。

结论： 

双侧 BIS 监测无法检测癫痫患者癫痫发作的发生情况。