Показатели количественной электроэнцефалографии у детей с острым гнойным менингитом

Abstract

Our aim was the assessment of the bioelectrical activity of the brain in children with bacterial meningitis in its acute period. 31 children were enrolled: 16 children with acute bacterial meningitis (8.9 ± 2.4 years) in 1–6 days from the onset of the disease, hospitalized to The Pediatric Research and Clinical Center for Infectious Diseases with a laboratory-confirmed diagnosis of bacterial meningitis (Neisseria meningitidis (n = 11), Streptococcus pneumoniae (n = 2), unspecified etiology (n = 3)) and 15 healthy controls. The electroencephalogram (EEG) was recorded in all children using a 16-channel electroencephalograph “Neuron-Spectrum 4/VP”. The clinical evaluation of the EEG included an analysis of the background rhythm, zonal differences, and the identification of pathological types of activity. The quantitative assessment consisted of the parameters of the average power (μV2) and amplitude (μV) of the alpha, theta and delta rhythms, as well as the ratio of the average spectral power – alpha/theta, alpha/delta. The visual analysis of EEG revealed a diffuse slowing with the registration of delta and theta waves in 100% of children in the acute period of bacterial meningitis. Focal changes were recorded in 18,8% of cases (3 patients). Periodic activity wasn’t recordedin any case. There was a significant decrease in the ratio of alpha/delta (p = 0.001) and alpha/theta (p = 0.048) spectra. Using ROC analysis, it was determined that an alpha/theta value less than 0.18 and an alpha/delta value less than 0.02 (a sensitivity 100%, a specificity 80%, AUROC 0.9) may indicate the likely development of cerebral edema. Thus, in pediatric patients with acutebacterial meningitis, a significant disorder of the normal ratio of the power of alpha/theta and alpha/delta rhythms on the EEG is recorded, which is presumably associated with inhibition of the functional activity of the thalamus and thalamo-cortical pathways, as well as the reticular formation of the brain.