Title ELEKTROENCEFALOGRAFIJA U DIJAGNOSTICI I PRAĆENJU DJECE AUTISTIČNOG SPEKTRA
Title (english) ELECTROENCEPHALOGRAPHY IN DIAGNOSIS AND MONITORING OF CHILDREN WITH AUTISTIC SPECTRUM DISORDER
Author Kristina Kampić
Mentor Igor Prpić (mentor)
Committee member Srđan Banac (predsjednik povjerenstva)
Committee member Ingrid Škarpa - Prpić (član povjerenstva)
Committee member Vesna Barac-Latas (član povjerenstva)
Granter University of Rijeka Faculty of Medicine (Department of Pediatrics) Rijeka
Defense date and country 2018-07-13, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Pediatrics
Abstract UVOD: Poremećaj iz autističnog spektra poznat u literaturi kao pervazivni razvojni poremećaj, sa sve većom prevalencijom i incidencijom, kako u Hrvatskoj tako i u svijetu, zabrinjava liječnike i znanstvenike. Unatoč ranim simptomima i znakovima koji se javljaju od 12 do 18 mjeseca života, poremećaj iz autističnog spektra otkriva nakon što dijete ne progovori u dobi od 3 do 4 godine. Prilikom obrade pacijenata s poremećajem iz autističnog spektra, osim detaljne (hetero)anamneze i fizikalnog pregleda, primjenjuje se i elektroencefalografija, kao metoda kojom uočavamo promjene električne aktivnosti mozga. Električna aktivnost mozga može biti normalna tj. uredna ili može pokazivati granične ili patološke promjene, kako smo ih i mi prikazali u našem istraživanju.
CILJ ISTRAŽIVANJA: Svrha našeg istraživanja je bila ispitati značenje elektroencefalografije u postavljanju dijagnoze i praćenju djece sa poremećajima iz autističnog spektra.
MATERIJALI I METODE: Retrospektivnom analizom povijesti bolesti i sve ostale dostupne medicinske dokumentacije te tako i elektroencefalografskih nalaza opisanih od strane neuropedijatara u Kliničkom bolničkom centru Rijeka, Klinike za pedijatriju, Zavoda za neurologiju i dječju psihijatriju uključili smo u istraživanje ukupno 72 djece koja su prema svih kriterijima mogla biti dio istraživanja. Podaci su prikazani ukupnim brojem i postotnim udjelom, a mjerene varijable prikazane su deskriptivnim pokazateljima.
REZULTATI: Od ukupnog broja djece u istraživanju (n=72), 45 djece je imalo napravljen EEG zapis. Statistički značajno manje EEG zapisa je učinjeno u djevojčica (p=0.00001). Elektroencefalografski nalazi su kod 71,1% djece (n=32) bili uredni - 25 muške djece i 7 ženske djece. Elektroencefalografske nalaze djece radilo se tijekom budnosti i spavanja. U troje djece je spavanje potpomognuto melatoninom dok je u jednog djeteta provedena kraća deprivacija spavanja. U 36 djece EEG je registriran u spavanju dok ih je u 9 učinjeno u budnosti. EEG nalaz u budnosti kod sve djece je bio normalan, a u spavanju su bila 23 normalna, 6 graničnih i 7 patoloških EEG nalaza. Statistički značajno je dokazano više patoloških i graničnih nalaza tijekom registracije EEG-a u spavanju što ukazuje na veću osjetljivost takvog načina registracije u djece s poremećajem iz autističnog spektra.
ZAKLJUČAK: Iz navedenih rezultata možemo uočiti kako većina djece s poremećajem iz autističnog spektra ima uredan i normalan EEG nalaz. Unatoč važnosti primjene ove metode kod primarne obrade djece s poremećajem iz autističnog spektra zbog široke diferencijalno dijagnostičke lepeze, smatramo kako kod jasne kliničke slike poremećaja iz autističnog spektra ova metoda nije nužna. Također, potrebna su dodatna istraživanja na većem broju ispitanika i daljnje praćenje i edukacija o poremećajima iz autističnog spektra radi lakšeg otkrivanja i ranijeg dijagnosticiranja ovih poremećaja.
Abstract (english) INTRODUCTION: The autism spectrum disorder known in the literature as a pervasive developmental disorder is making doctors and scientists very concerned with its increasing prevalence and incidence, both in Croatia and worldwide. Despite the early symptoms occurring between 12 and 18 months of life, an autism spectrum disorder is usually detected after the child's lack of speech production at the age of 3 to 4 years. When treating patients with autism spectrum disorder, apart from detailed (hetero) anamnesis and physical examination, electroencephalography is also used as a method for detecting changes in brain electrical activity. The electrical activity of the brain may be normal, but it also may show borderline or pathological changes, as we have shown that in our research.
AIM: Our research goal was to examine the purpose of electroencephalography in diagnosing and monitoring children with autism spectrum disorder.
MATERIAL AND METHODS: Through a retrospective analysis of the history of the disease and all available medical documentation as well as the electroencephalographic reports described by the neuropediatricians in the Clinical Hospital Center of Rijeka, the Pediatric Clinic, the Department of Neurology, and Pediatric Psychiatry, we included in the research of 72 children who match the given criteria. The data are represented by the total number and percentage share, and the measured variables are presented through descriptive indicators. RESULTS: Of the total number of children in the study (n = 72), 45 children had an EEG report. A statistically significant less EEG report was done in a girl (p = 0.00001). Electroencephalographic reports in 71.1% of children (n = 32) were normal - 25 male and 7 female children. Electroencephalographic reports of children were done during wakefulness and sleep. Three children were sleep-induced with melatonin while one child had a shorter sleep deprivation. In 36 children, the EEG was registered in sleep while at 9 in the wakefulness. The EEG report in the wakefulness in all children was normal and in sleeping was 23 normal, 6 border and 7 pathologic EEG reports. Statistically significant more pathological and border EEG reports were found during EEG sleep regression, indicating a greater sensitivity of such a method of registering in children with autism spectrum disorder.
CONCLUSION: From the above results we can see that most children with autism spectrum disorder have a neat and normal EEG report. Despite the importance of using this method in the primary treatment of children with autism spectrum disorder due to the wide differential diagnosis, we argue that for a clear clinical picture of the autism spectrum disorder this method is not necessary. Furthermore, more research needs to be conducted on a larger number of subjects and further monitoring and education on autism spectrum disorder is also needed in order to facilitate detection and early diagnosis of these disorders.
Keywords
poremećaj iz autističnog spektra
elektroencefalografija
diferencijalna dijagnostika
klinička slika
Keywords (english)
autism spectrum disorder
electroencephalography
differential diagnosis
clinical picture
Language croatian
URN:NBN urn:nbn:hr:184:930513
Study programme Title: Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2018-11-19 15:07:49