Clinical and EEG features of patients with ictal EEG pattern
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Ria Damayanti(1*), Machlusil Husna(2), Akhmad Syahrir(3)
(1) Division of Epilepsy, Neurology Department of the Faculty of Medicine Brawijaya University, Saiful Anwar General Hospital, Malang, Indonesia
(2) Division of Epilepsy, Neurology Department of the Faculty of Medicine Brawijaya University, Saiful Anwar General Hospital, Malang, Indonesia
(3) Division of Epilepsy, Neurology Department of the Faculty of Medicine Brawijaya University, Saiful Anwar General Hospital, Malang, Indonesia
(*) Corresponding Author
Abstract
Electroencephalography (EEG) provides important information about the diagnosis and management of epilepsy patients. Unfortunately, analysis of EEG pattern for patient with clinical seizure in EEG laboratory remains inadequate. This study aimed to characterize the clinical and EEG features of patient with ictal EEG pattern.
We characterized 1,793 patients with ictal EEG pattern in Saiful Anwar General Hospital during 2013-2015. The EEG records were analyzed by an electroencephalographer. Demographic and clinical data were also collected.
The prevalence of patients with ictal EEG pattern was 1% (19/1793). The means of age were 20,54 ± 15,93 years (male) and 14,25 ± 10,82 years (female). The onset of seizure was most common during the first decade of life. Eighteen patients (95%) had poor seizure control. We found 16 ictal EEG patterns with focal onset (84%) and 3 ictal EEG patterns with generalized onset (16%). From clinical findings, we found 11 patients with focal seizure (58%) and 8 patients with generalized seizure (42%). From patient with clinical generalized seizure, we found 5 EEG patterns with focal onset (62%) and 3 EEG patterns with generalized onset (38%). All of the focal onset in this study were focal to bilateral onset (100%), consist of 9 patients with focal to bilateral seizure (82%), 1 patient with focal aware seizure (9%) and 1 patient with focal impaired awareness seizure (9%).
This study revealed the variability of clinical and electrophysiologic features in patient with ictal EEG pattern. The ictal EEG pattern could be different from the clinical seizure during recording.
ABSTRAK
Elektroensefalografi (EEG) memberikan informasi penting mengenai diagnosis dan manajemen pasien epilepsi. Akan tetapi, analisis pola EEG pada pasien dengan kejang klinis di laboratorium EEG masih belum memadai. Penelitian ini bertujuan untuk memperlihatkan karakter klinis dan EEG pasien dengan pola EEG iktal.
Kami menemukan 1.793 pasien dengan pola EEG iktal di Rumah Sakit Umum Saiful Anwar selama 2013-2015. Rekaman EEG dianalisis oleh seorang elektroensefalografer. Data demografi dan klinis juga dikumpulkan.
Prevalensi pasien dengan pola EEG iktal adalah 1% (19/1793). Rerata umur 20,54±15,93 tahun (laki-laki) dan 14,25±10,82 tahun (perempuan). Serangan kejang paling umum terjadi selama dekade pertama kehidupan. Delapan belas pasien (95%) memiliki kontrol kejang yang buruk. Kami menemukan 16 pola EEG iktal dengan awitan fokal (84%) dan 3 pola EEG iktal dengan awitan umum (16%). Berdasarkan temuan klinis, kami menemukan 11 pasien dengan kejang fokal (58%) dan 8 pasien dengan kejang umum (42%). Dari pasien dengan kejang umum klinis, kami menemukan 5 pola EEG dengan onset fokal (62%) dan 3 pola EEG dengan onset umum (38%). Semua awitan fokal dalam penelitian ini adalah awitan fokal yang berkembang menjadi bilateral (100%), terdiri dari 9 pasien dengan kejang fokal yang berkembang menjadi bilateral (82%), 1 pasien dengan kejang sadar fokal (9%), dan 1 pasien kejang fokal dengan gangguan kesadaran (9%).
Hasil penelitian menunjukkan adanya keragaman gambaran klinis dan elektrofisiologi pada pasien dengan pola EEG iktal. Pola EEG iktal bisa berbeda dari kejang klinis selama perekaman.
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