Loading...
2 results
Search Results
Now showing 1 - 2 of 2
- Impacto do EEG Ambulatório de 24 Horas na abordagem clínica a doentes com suspeita de EpilepsiaPublication . Batista, Carla; Borges, Daniel Filipe; Coelho, Paulo; Ferreira, Axel; Pereira, Telmo; Conde, JorgeIntrodução: O eletroencefalograma constitui a técnica gold-standard para avaliar a atividade cortical epileptógenea. No entanto, a sua sensibilidade revela-se baixa nas modalidades de registo de curta duração, sendo que, neste contexto, a utilização do EEG Ambulatório de 24 horas (EEGa) veio permitir uma maior capacidade diagnóstica, enquanto registo prolongado, a custos controlados. Objetivo: Analisar o impacto do EEGa na avaliação de doentes com suspeita de epilepsia, através da sua sensibilidade e especificidade para esse diagnóstico clínico. Secundariamente, a) avaliar a sensibilidade em função da distância temporal à última crise, b) averiguar se existe relação entre a presença de atividade paroxística e lesão, c) avaliar o follow-up dos doentes e d) determinar possíveis fatores preditivos. Material e Métodos: Estudo observacional retrospetivo de uma amostra contínua dos pacientes com suspeita de epilepsia que realizaram EEGa entre maio de 2011 e maio de 2018 no Laboratório de Neurofisiologia da Unidade Local de Saúde de Matosinhos. Resultados: Amostra de 83 indivíduos, com idade média de 44.5 anos (79 adultos e 4 pediátricos). A sensibilidade foi de 97% e especificidade de 73% para o diagnóstico de epilepsia, com uma taxa de falsos positivos e falsos negativos de 5% e 7%, respetivamente. Conclusões: O EEGa deve ser um estudo neurofisiológico a considerar mais frequentemente na prática clínica, almejando um diagnóstico mais precoce de epilepsia ou contrariando este, designadamente nos casos em que os exames de primeira linha sejam normais e a convicção clínica permaneça. A brevidade obtida para o diagnóstico evita as expectáveis e demais consequências.
- Clinical usefulness of the electroencephalogram in acute stroke: a preliminary studyPublication . Borges, Daniel Filipe; Silva, Mariana; Ferreira, Axel; Coelho, Paulo Simões; Pereira, Telmo; Conde, JorgeIntroduction: Stroke is the main cause of disability worldwide, being the first cause of death in Portugal. In the first hours of the event, the cranioencephalic CT scan (CT Scan) does not show the lesion in about 74% of cases, making validation of alternative diagnostic approaches of utmost importance. The electroencephalogram (EEG) may provide useful information for the diagnosis and prognosis of stroke. Objective: To study the potential usefulness of the EEG for the early diagnosis of acute stroke in patients with initial negative CT Scan, and for the evaluation of the functional status and risk of epilepsy. Methods: Retrospective analysis of patients with ischemic stroke who underwent EEG and acute phase CT scan between January 2014 and February 2018. Patient characteristics and stroke were classified according to the Oxfordshire Community Stroke Project (OCSP) criteria. The patients were functionally evaluated at 12 months post-stroke by the modified Rankin Scale (mRS) and the existence of post-stroke epilepsy was determined by telephone interview on February 2018. Results: Thirty patients (25 females and 5 males, mean age 70.5 years) were included. According to the OCSP were identified: 40% TACS, 37% PACS, 10% LACS and 13% POCS. 50% with acute vascular injury visible on the initial CT Scan performed with 7 hours of evolution in median. All patients underwent EEG with a median of 3 days of evolution, and slow focal activity was observed in all patients, and focal paroxysmal activity (PA) was seen in 17% of the participants. 17 patients (58% of patients) developed post-stroke epilepsy (PSE) with 4 of these having PA evidence in the initial EEG (24%). One of the patients with PA in the initial EEG did not develop epilepsy during a 4 years follow-up period. In patients without PA, the average of mRs at follow-up was 3.8 and the mortality was 24%, whereas in patients with PA, the mean of the mRs was 5.0 and the mortality was 40%. Conclusion: In this study, unlike CT Scan, the acute-phase EEG presented with abnormal features in all patients with acute stroke, therefore the EEG may potentially provide significant diagnostic information, estimates of risk for developing future epilepsy and also overall risk stratification. Further studies are needed to validate this hypothesis.