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摘要: 准确监测痫性发作对于有效评估癫痫患者口服抗癫痫药的临床疗效,以及获取可靠的临床研究数据具有重要意义。然而,临床工作中患者本人记录的痫性发作频率远低于脑电图监测的频率,因此研发准确便携的长程脑电图监测新技术尤为迫切。本文对痫性发作监测技术的最新进展作一综述。Abstract: Documenting the seizure attack accurately is curial for evaluating the medical treatment for epileptic patients and acquiring reliable data from clinical trials. However, nearly half of all seizures captured during the long-term video-electroencephalography monitoring were not reported by patients. Therefore, innovative and feasible tools for automatic seizure detection are in great demand. This article reviewed the most recent advances in the technique of seizure detection.
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Key words:
- epilepsy /
- seizure,detection /
- seizure under-reporting
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表 1 不同癫痫发作监测技术的优势与劣势
监测技术 优势 劣势 经颅监测 •脑电图是最重要的癫痫监测手段,可进行长程动态监测 •颅内植入电极为有创操作 •可监测到无或仅有轻微运动情况的癫痫发作,准确可靠 •尚无法准确进行自动数据分析 •可见的电极导致癫痫患者被歧视 运动监测 •不依赖于脑电图进行监测 •对非惊厥性痫性发作的监测效果欠佳 •可有效监测惊厥性痫性发作 •基于摄像的监测设备无法脱离家庭环境 •可有效监测夜间痫性发作 自主神经症状监测 •可持续监测患者心率、血压以及血氧饱和度,进而实现对痫性发作的自动监测 •无法区别日常生活中的兴奋、恐惧等情绪变化 行为学监测 •一些癫痫手机软件可提供痫性发作报警功能 •报警功能需主动按下紧急呼叫按钮,大多数患者无法完
成，仍需进一步改进•患者可通过其记录癫痫发作情况 多模式监测 •对全面性强直痉挛发作及部分性发作监测的灵敏度高 •对非惊厥性痫性发作的监测较为困难 
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[1] Fisher RS, van Emde BW, Blume W, et al. Epileptic seizures and epilepsy:definitions proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE)[J]. Epilepsia, 2005, 46:470-472. doi: 10.1111/j.0013-9580.2005.66104.x [2] 肖波,周罗. 癫痫最新临床诊疗指南:机遇与挑战并存[J]. 协和医学杂志, 2017, 8:122-126. http://www.cnki.com.cn/Article/CJFDTOTAL-XHYX2017Z1009.htm [3] Beghi E. Addressing the burden of epilepsy:Many unmet needs[J]. Pharmacol Res, 2016, 107:79-84. doi: 10.1016/j.phrs.2016.03.003 [4] Schmidt D, Schachter SC.Drug treatment of epilepsy in adults[J]. BMJ, 2014, 348:g254. http://onlinelibrary.wiley.com/resolve/reference/PMED?id=24583319 [5] Van de Vel A, Milosevic M, Bonroy B, et al. Long-term accelerometry-triggered video monitoring and detection of tonic-clonic and clonic seizures in a home environment:Pilot study[J]. Epilepsy Behav Case Rep, 2016, 5:66-71. doi: 10.1016/j.ebcr.2016.03.005 [6] Fisher RS, Blum DE, Diventura B, et al. Seizure diaries for clinical research and practice:limitations and future prospects[J]. Epilepsy Behav, 2012, 24:304-310. doi: 10.1016/j.yebeh.2012.04.128 [7] Blum DE, Eskola J, Bortz JJ, et al. Patient awareness of seizures[J]. Neurology, 1996, 47:260-264. doi: 10.1212/WNL.47.1.260 [8] Cook MJ, O'Brien TJ, Berkovic SF, et al. Prediction of seizure likelihood with a long-term, implanted seizure advisory system in patients with drug-resistant epilepsy:a first-in-man study[J]. Lancet Neurol, 2013, 12:563-571. doi: 10.1016/S1474-4422(13)70075-9 [9] Hamandi K, Beniczky S, Diehl B, et al. Current practice and recommendations in UK epilepsy monitoring units. Report of a national survey and workshop[J]. Seizure, 2017, 50:92-98. doi: 10.1016/j.seizure.2017.06.015 [10] 卢强,金丽日,周祥琴,等. 额叶非惊厥性癫痫持续状态临床和脑电图特征[J]. 协和医学杂志, 2012, 3:318-322. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=xhyx201203016 [11] Hoppe C, Poepel A, Elger CE. Epilepsy:accuracy of patient seizure counts[J]. Arch Neurol, 2007, 64:1595-1599. doi: 10.1001/archneur.64.11.1595 [12] Elger CE, Mormann F. Seizure prediction and documentation-two important problems[J]. Lancet Neurol, 2013, 12:531-532. doi: 10.1016/S1474-4422(13)70092-9 [13] Detyniecki K, Blumenfeld H. Consciousness of seizures and consciousness during seizures:are they related?[J]. Epilepsy Behav, 2014, 30:6-9. doi: 10.1016/j.yebeh.2013.09.018 [14] Debener S, Emkes R, De Vos M, et al. Unobtrusive ambulatory EEG using a smartphone and flexible printed electrodes around the ear[J]. Sci Rep, 2015, 5:16743. doi: 10.1038/srep16743 [15] Zibrandtsen IC, Kidmose P, Christensen CB, et al. Ear-EEG detects ictal and interictal abnormalities in focal and generalized epilepsy-A comparison with scalp EEG monitor-ing[J]. Clin Neurophysiol, 2017, 128:2454-2461. doi: 10.1016/j.clinph.2017.09.115 [16] Gu Y, Cleeren E, Dan J, et al. Comparison between Scalp EEG and Behind-the-Ear EEG for Development of a Wearable Seizure Detection System for Patients with Focal Epilepsy[J]. Sensors (Basel), 2017, 18:29. doi: 10.3390/s18010029 [17] Grant AC, Abdel-Baki SG, Omurtag A, et al. Diagnostic accuracy of microEEG:a miniature, wireless EEG device[J]. Epilepsy Behav, 2014, 34:81-85. doi: 10.1016/j.yebeh.2014.03.015 [18] Tewolde S, Oommen K, Lie DY, et al. Epileptic Seizure Detection and Prediction Based on Continuous Cerebral Blood Flow Monitoring-a Review[J]. J Healthc Eng, 2015, 6:159-178. doi: 10.1260/2040-2295.6.2.159 [19] Jeppesen J, Beniczky S, Johansen P, et al. Exploring the capability of wireless near infrared spectroscopy as a portable seizure detection device for epilepsy patients[J]. Seizure, 2015, 26:43-48. doi: 10.1016/j.seizure.2015.01.015 [20] Baldassano SN, Brinkmann BH, Ung H, et al. Crowdsourc-ing seizure detection:algorithm development and validation on human implanted device recordings[J]. Brain, 2017, 140:1680-1691. doi: 10.1093/brain/awx098 [21] Kandler R, Ponnusamy A, Wragg C. Video ambulatory EEG:A good alternative to inpatient video telemetry?[J]. Seizure, 2017, 47:66-70. doi: 10.1016/j.seizure.2017.02.010 [22] Van de Vel A, Smets K, Wouters K, et al. Automated non-EEG based seizure detection:Do users have a say?[J]. Epilepsy Behav, 2016, 62:121-128. doi: 10.1016/j.yebeh.2016.06.029 [23] Pediaditis M, Tsiknakis M, Leitgeb N. Vision-based motion detection, analysis and recognition of epileptic seizures-a systematic review[J]. Comput Methods Programs Biomed, 2012, 108:1133-1148. doi: 10.1016/j.cmpb.2012.08.005 [24] Beniczky S, Polster T, Kjaer TW, et al. Detection of generalized tonic-clonic seizures by a wireless wrist accelerometer:a prospective, multicenter study[J]. Epilepsia, 2013, 54:e58-e61. doi: 10.1111/epi.12120 [25] Szabo CA, Morgan LC, Karkar KM, et al. Electromyography-based seizure detector:Preliminary results comparing a generalized tonic-clonic seizure detection algorithm to video-EEG recordings[J]. Epilepsia, 2015, 56:1432-1437. doi: 10.1111/epi.13083 [26] Beniczky S, Conradsen I, Moldovan M, et al. Quantitative analysis of surface electromyography during epileptic and nonepileptic convulsive seizures[J]. Epilepsia, 2014, 55:1128-1134. doi: 10.1111/epi.12669 [27] Hampel KG, Jahanbekam A, Elger CE, et al. Seizure-related modulation of systemic arterial blood pressure in focal epilepsy[J]. Epilepsia, 2016, 57:1709-1718. doi: 10.1111/epi.13504 [28] Thomas SS, Nathan V, Zong C, et al. BioWatch:A Noninvasive Wrist-Based Blood Pressure Monitor That Incorporates Training Techniques for Posture and Subject Variability[J]. IEEE J Biomed Health Inform, 2016, 20:1291-1300. doi: 10.1109/JBHI.2015.2458779 [29] Fisher RS, Bartfeld E, Cramer JA. Use of an online epilepsy diary to characterize repetitive seizures[J]. Epilepsy Behav, 2015, 47:66-71. doi: 10.1016/j.yebeh.2015.04.022 [30] Furbass F, Kampusch S, Kaniusas E, et al. Automatic multimodal detection for long-term seizure documentation in epilepsy[J]. Clin Neurophysiol, 2017, 128:1466-1472. doi: 10.1016/j.clinph.2017.05.013 -
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