Journal of Shandong University (Health Sciences) ›› 2022, Vol. 60 ›› Issue (9): 91-96.doi: 10.6040/j.issn.1671-7554.0.2022.0654

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Correlation between EEG variations and BASED evaluation of the efficacy of ACTH treatment in 54 cases of infantile spasms

ZHENG Su, CHEN Shuhua, LI Hua, DENG Jie, CHEN Chunhong, WANG Xiaohui, FENG Weixing, HAN Xiaodi, ZHANG Yujia, LI Na, LI Mo, FANG Fang   

  1. Department of Neurology, Beijing Childrens Hospital, Capital Medical University, National Center for Childrens Health, Beijing 100045, China
  • Published:2022-09-02

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Abstract: Objective To explore the characteristics of electroencephalogram(EEG)after adrenocorticotropic hormone(ACTH)treatment and the efficacy in patients with infantile spasm(IS). Methods Clinical and EEG data of 54 IS patients treated with ACTH during Nov. 2019 and Apr. 2021 were retrospectively analyzed. EEG analysis included background activity(slow waves)and epileptic discharges(epileptic waves and hypsarrhythmia). Changes of EEG before and after ACTH treatment were evaluated with burden of amplitudes and epileptiform discharges score(BASED). According to whether epileptic seizure occurred 14 days after ACTH treatment, the patients were divided into none-seizure group(n=29)and seizure group(n=25). The changes of EEG before and after ACTH treatment were compared between the groups. Results Focal slow wave was observed in 18 cases and focal epileptic wave in 28 cases in the non-seizure group, which were significantly higher than those in the seizure group(P<0.05), while hypsarrhythmia was observed in 1 case in the non-seizure group, which was significantly lower than that in the seizure group(P<0.05). BASED results showed that EEG remission was observed in 26 cases in the non-seizure group, which was significantly higher than that in the seizure group(7 cases, P<0.000 1), and the EEG remission was consistent with the clinical efficacy(P<0.001). During the follow-up of 12 to 29 months, spasm recurred in 9 and 16 cases in the non-seizure group and seizure group, respectively, and the control rates of spasm were 68.97% and 36%, respectively. Conclusion There is a certain correlation between the characteristics of interictal EEG and clinical efficacy. The BASED result shows that EEG remission after ACTH treatment indicates good clinical efficacy. Thus, the quantification on BASED can assist the evaluation of clinical efficacy.

Key words: Infantile spasm, Adrenocorticotrophic hormone, Video electroencephalogram, Burden of amplitudes and epileptiform discharges score, Prognosis

CLC Number: 

  • R742.1
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