Objective: To determine the factors associated with seizures in systemic lupu s erythematosus (SLE). Methods: One hundred ninety- five patients with SLE were followed at the University of Maryland Lupus Clinics from J...Objective: To determine the factors associated with seizures in systemic lupu s erythematosus (SLE). Methods: One hundred ninety- five patients with SLE were followed at the University of Maryland Lupus Clinics from January 1992 until Ju ne 2004. Neuropsychiatric (NP) manifestations were defined according to the Amer ican College of Rheumatology nomenclature and case definitions for NP- SLE synd romes, and seizures were defined using the International Classification of Epile ptic Seizures. At the end of the study period, 28 of the 195 (14% )- patients with SLE had seizures (21 generalized convulsive, 7 partial) during their course of disease. Recurrent seizures or epilepsy occurred in 12 of 28 patients (43% ). The baseline features of those patients with seizures and those without them were compared to determine their contribution to the occurrence of isolated seiz ures and epilepsy. Results: Isolated seizures in SLE are common; epilepsy is les s frequent but nonetheless important. Certain clinical features at baseline were independent predictors of seizures including disease activity, in particular ps ychosis, moderate- to high- titer serum anti- cardiolipin and anti- Smith an tibodies, and damage accrual. Higher disease activity at baseline, concurrent mu ltiple NP- SLE manifestations, prior strokes, and male gender were predictive o f epilepsy. Conclusion: The risk of seizure and epilepsy in systemic lupus eryth ematosus (SLE) is increased in those patients with higher disease activity at ba seline, prior neuropsychiatric SLE disease, and anti- cardiolipin and anti- Sm ith antibodies.展开更多
Objective: Describe and evaluate a neural network method for automatic and incremental learning applied to patient-dependent seizure detection. Compare the classification ability of various time-frequency methods incl...Objective: Describe and evaluate a neural network method for automatic and incremental learning applied to patient-dependent seizure detection. Compare the classification ability of various time-frequency methods including FFT spectrogram, spectral edge frequency and bicoherence. Methods: 57 seizures from 10 epilepsy patients are used. A probabilistic neural network (PNN) is trained and incrementally updated in a novel fashion. The speed and accuracy of the method is evaluated with different training parameters and time-frequency methods. Results: Training the PNN on a single seizure from each record offers better performance (sensitivity=0.89 and false-positive-rate=0.56/h) than 3 patient-independent seizure detection algorithms. The method is virtually unaffected by the settings of various training parameters. Training is very fast (0.9 s), and the accuracy improves as more examples are added incrementally (without retraining). The overall best time-frequency method was the FFT spectrogram. The bicoherence plus the FFT spectrogram was the best method on 4 records, improving the correlation from 0.111 to 0.940 on one and from 0.288 to 0.612 on another. Conclusions: The proposed method offers accurate, robust and virtually instantaneous training and incremental learning when applied to patient-dependent seizure detection. Significance: Accurate seizure detection can improve patient care in both the epilepsy monitoring unit and the intensive care unit. Future applications include patientindependent algorithms that continue to learn as new examples are encountered.展开更多
国际抗癫痫联盟(International League Against Epilepsy,ILAE)是全球癫痫学术领域最权威的专业组织。ILAE根据人们对癫痫的最新认识,不定期对癫痫的国际分类和术语进行修订。其最早于1960年提出了国际癫痫分类;1981年确定了癫痫发作的...国际抗癫痫联盟(International League Against Epilepsy,ILAE)是全球癫痫学术领域最权威的专业组织。ILAE根据人们对癫痫的最新认识,不定期对癫痫的国际分类和术语进行修订。其最早于1960年提出了国际癫痫分类;1981年确定了癫痫发作的分类;1989年确定了癫痫和癫痫综合征的分类;2001年再次进行修订,提出了癫痫发作和癫痫诊断方案的建议。展开更多
癫痫是一大类不同病因、不同电临床表现和具有显著临床预后差异的病症/疾病。2017年国际抗癫痫联盟(International League Against Epilepsy,ILAE)癫痫分类方案定义了三个诊断层次,包括癫痫发作类型、癫痫类型和癫痫综合征,并且强调必...癫痫是一大类不同病因、不同电临床表现和具有显著临床预后差异的病症/疾病。2017年国际抗癫痫联盟(International League Against Epilepsy,ILAE)癫痫分类方案定义了三个诊断层次,包括癫痫发作类型、癫痫类型和癫痫综合征,并且强调必须在每个诊断层次上均需要考虑病因和共患病。展开更多
目的 分析住院病案首页中癫痫编码现状,提出相应措施提升编码质量。方法 在某三级医院住院病案首页管理系统中以主要诊断编码包含癫痫G40和癫痫持续状态G41为检索条件,筛选2020年1月1日至2020年12月31日神经内、外科出院病案,由神经科...目的 分析住院病案首页中癫痫编码现状,提出相应措施提升编码质量。方法 在某三级医院住院病案首页管理系统中以主要诊断编码包含癫痫G40和癫痫持续状态G41为检索条件,筛选2020年1月1日至2020年12月31日神经内、外科出院病案,由神经科医师参考临床诊疗指南癫痫分册及2017版国际抗癫痫联盟(International League Against Epilepsy,ILAE)癫痫分类作为癫痫诊断和分类的标准,与资深编码员共同对编码进行核查,回顾性分析癫痫编码情况。结果 审核的456份癫痫病案中,错误编码共计131份,错误率为28.73%。其中19份类目编码错误,错误率为4.17%;112份亚目编码错误,错误率为24.56%。残余类目G40.9的错误构成比最高。总结存在的编码缺陷类型为主要诊断选择错误、癫痫类型编码错误以及存在大量残余类目编码。结论 癫痫类目编码错误率不高,但亚目编码错误率较高,主要由于编码员对临床的癫痫类型分类不够了解。加强编码员临床知识的培训,规范临床医师的诊断书写习惯,借助结构化的电子病历诊断模板,以提高编码质量。展开更多
文摘Objective: To determine the factors associated with seizures in systemic lupu s erythematosus (SLE). Methods: One hundred ninety- five patients with SLE were followed at the University of Maryland Lupus Clinics from January 1992 until Ju ne 2004. Neuropsychiatric (NP) manifestations were defined according to the Amer ican College of Rheumatology nomenclature and case definitions for NP- SLE synd romes, and seizures were defined using the International Classification of Epile ptic Seizures. At the end of the study period, 28 of the 195 (14% )- patients with SLE had seizures (21 generalized convulsive, 7 partial) during their course of disease. Recurrent seizures or epilepsy occurred in 12 of 28 patients (43% ). The baseline features of those patients with seizures and those without them were compared to determine their contribution to the occurrence of isolated seiz ures and epilepsy. Results: Isolated seizures in SLE are common; epilepsy is les s frequent but nonetheless important. Certain clinical features at baseline were independent predictors of seizures including disease activity, in particular ps ychosis, moderate- to high- titer serum anti- cardiolipin and anti- Smith an tibodies, and damage accrual. Higher disease activity at baseline, concurrent mu ltiple NP- SLE manifestations, prior strokes, and male gender were predictive o f epilepsy. Conclusion: The risk of seizure and epilepsy in systemic lupus eryth ematosus (SLE) is increased in those patients with higher disease activity at ba seline, prior neuropsychiatric SLE disease, and anti- cardiolipin and anti- Sm ith antibodies.
文摘Objective: Describe and evaluate a neural network method for automatic and incremental learning applied to patient-dependent seizure detection. Compare the classification ability of various time-frequency methods including FFT spectrogram, spectral edge frequency and bicoherence. Methods: 57 seizures from 10 epilepsy patients are used. A probabilistic neural network (PNN) is trained and incrementally updated in a novel fashion. The speed and accuracy of the method is evaluated with different training parameters and time-frequency methods. Results: Training the PNN on a single seizure from each record offers better performance (sensitivity=0.89 and false-positive-rate=0.56/h) than 3 patient-independent seizure detection algorithms. The method is virtually unaffected by the settings of various training parameters. Training is very fast (0.9 s), and the accuracy improves as more examples are added incrementally (without retraining). The overall best time-frequency method was the FFT spectrogram. The bicoherence plus the FFT spectrogram was the best method on 4 records, improving the correlation from 0.111 to 0.940 on one and from 0.288 to 0.612 on another. Conclusions: The proposed method offers accurate, robust and virtually instantaneous training and incremental learning when applied to patient-dependent seizure detection. Significance: Accurate seizure detection can improve patient care in both the epilepsy monitoring unit and the intensive care unit. Future applications include patientindependent algorithms that continue to learn as new examples are encountered.
文摘国际抗癫痫联盟(International League Against Epilepsy,ILAE)是全球癫痫学术领域最权威的专业组织。ILAE根据人们对癫痫的最新认识,不定期对癫痫的国际分类和术语进行修订。其最早于1960年提出了国际癫痫分类;1981年确定了癫痫发作的分类;1989年确定了癫痫和癫痫综合征的分类;2001年再次进行修订,提出了癫痫发作和癫痫诊断方案的建议。
文摘癫痫是一大类不同病因、不同电临床表现和具有显著临床预后差异的病症/疾病。2017年国际抗癫痫联盟(International League Against Epilepsy,ILAE)癫痫分类方案定义了三个诊断层次,包括癫痫发作类型、癫痫类型和癫痫综合征,并且强调必须在每个诊断层次上均需要考虑病因和共患病。
文摘目的 分析住院病案首页中癫痫编码现状,提出相应措施提升编码质量。方法 在某三级医院住院病案首页管理系统中以主要诊断编码包含癫痫G40和癫痫持续状态G41为检索条件,筛选2020年1月1日至2020年12月31日神经内、外科出院病案,由神经科医师参考临床诊疗指南癫痫分册及2017版国际抗癫痫联盟(International League Against Epilepsy,ILAE)癫痫分类作为癫痫诊断和分类的标准,与资深编码员共同对编码进行核查,回顾性分析癫痫编码情况。结果 审核的456份癫痫病案中,错误编码共计131份,错误率为28.73%。其中19份类目编码错误,错误率为4.17%;112份亚目编码错误,错误率为24.56%。残余类目G40.9的错误构成比最高。总结存在的编码缺陷类型为主要诊断选择错误、癫痫类型编码错误以及存在大量残余类目编码。结论 癫痫类目编码错误率不高,但亚目编码错误率较高,主要由于编码员对临床的癫痫类型分类不够了解。加强编码员临床知识的培训,规范临床医师的诊断书写习惯,借助结构化的电子病历诊断模板,以提高编码质量。
