EEG'de uyku evresinde görülen subklinik nöbetler ve fokal epilepsili hastalarda klinik önemi

Öz

Amaç: Çalışmalarda, subklinik nöbetlerin tanı, prognoz ve tedavi yanıtları üzerinde önemli bir etkisi olduğu gözlemlenmektedir. Çalışmamızın amacı, parsiyel epilepsi tanısı konmuş hastalarda bu nöbetlerin varlığını araştırmak, uyku ile ilişkilerini incelemek, tanıya katkılarını ve tedavi seçimi ile prognoz üzerindeki etkilerini değerlendirmektir. Materyal ve yöntem: EEG ünitesinde yapılan toplam 1,626 EEG incelendi. Bunların içinde, parsiyel epilepsi tanısı konmuş 626 hastaya ait EEG bulundu. Çalışmaya yirmi dakika EEG monitörizasyonu yapılan 140 hasta ve yirmi dört saat EEG monitörizasyonu yapılan 28 hasta dahil edildi. Bulgular: İki hasta grubu arasında karşılaştırmalı bir analiz yapıldı: biri yirmi dakika EEG'ye tabi tutulan diğeri 24 saat EEG monitörizasyonu yapılan. Dirençli epilepsi varlığında, SCS riski 3.1 kat artmaktadır. Frontal lob epilepsilerinde SCS varlığı, temporal lob epilepsilere kıyasla 2.2 kat daha yüksek bulundu (1,0-5,3). Levetirasetam kullanımı ile nöbetler arasında istatistiksel olarak anlamlı bir ilişki gözlemlendi (p=0,044). Risk oranı hesaplaması, Levetirasetam kullanımı ile nöbetlerin 1.2 kat (1-1.6) daha sık oluşma olasılığını gösterdi. Risk analizi, lakozamid-zonisamid gibi bilinen ilaçların kullanımı lehine nöbetlerin %1,5 kat (1,2-1,9) daha sık görüldüğünü ortaya koydu. Sonuç: Subklinik nöbetler, tanı, prognoz ve tedavi açısından giderek artan klinik öneme sahiptir. Bu nöbetlerin uyku ile ilişkisi, daha geniş hasta ve merkezlerle yapılacak gelecek araştırmalar için önem taşımaktadır.

Anahtar Kelimeler

• Subklinik nöbetler
• uyku
• fokal epilepsi

Subclinical seizures on EEG with sleep phases and clinical significance in patients with focal epilepsy

Abstract

Purpose: Studies have observed that subclinical seizures significantly impact diagnosis, prognosis, and treatment responses. The aim of our study is to investigate the presence of these seizures, their relationship with sleep, their contribution to diagnosis, and their impact on treatment selection and prognosis in patients diagnosed with partial epilepsy. Materials and methods: A total of 1.626 EEGs conducted in the EEG unit were examined. Among them, 626 were found to belong to patients diagnosed with partial epilepsy. 140 patients who underwent twenty-minute EEG monitoring and 28 patients who underwent twenty-four-hour EEG monitoring were included in the study. Results: A comparative analysis was conducted between two cohorts of patients: one subjected to a twenty-minute EEG and the other undergoing a 24-hour EEG. In the presence of resistant epilepsy, the risk of SCS is increased by 3.1 times. The presence of SCS in frontal lobe epilepsies demonstrated a 2.2-fold elevation compared to temporal lobe epilepsies (1.0-5.3). A statistically significant relationship between Levetiracetam usage and seizures was observed (p=0.044). The calculated Odds Ratio for risk indicated a 1.2-fold (1-1.6) higher frequency of seizures with Levetiracetam usage. Risk analysis revealed a 1.5-fold (1.2-1.9) higher incidence of seizures with the use of well-known drugs in favor of lacosamide-zonisamide. Conclusion: SCSs are gaining increasing clinical significance in terms of diagnosis, prognosis, and treatment. The relationship between these periods of sleep and SCSs is important for future research with a larger number of patients and medical professionals.

Keywords

• Subclinical seizures
• sleep
• focal epilepsy

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