Subdural recording of ictal DC shifts in neocortical seizures in humans
Subdural recording of ictal DC shifts in neocortical seizures in humans
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DOI：
10.1111/j.1528-1157.1996.tb00631.x
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发表时间：
1996-07-01
期刊：
影响因子：
5.6
通讯作者：
Shibasaki, H
中科院分区：
文献类型：
--
作者：
Ikeda, A;Terada, K;Shibasaki, H
目的：侵入性发作脑电图记录往往是必要的，以划定癫痫患者的顽固性部分性癫痫，但即使颅内发作记录往往揭示了不明确的发病区在新皮质癫痫。我们研究了在颅内记录的人类癫痫发作直流电（DC）电位的生理意义。方法：我们对3例顽固性部分性癫痫患者进行了颅内发作脑电图记录，和顶叶新皮质区的研究（两名患者为铂，一名患者为不锈钢），两种标准（1.5 Hz）和开路（0.016 Hz）低频滤波器（LFF）设置。结果：最初的发作模式定位于2至9个硬膜下电极，其特征在于非常低的电压和高频节律性活动（“电递减模式”）。2例患者在发作期EEG放电前1-10 s，在较窄的区域（2 ~ 6个电极）出现缓慢上升的负电位（DC电位）。结论：这些结果与以往动物发作期DC电位变化的研究结果一致，提示发作期DC电位变化有助于更准确地描绘人类癫痫的致痫区域。
Purpose: Invasive ictal EEG recording is often necessary to delineate epileptogenic areas in patients with intractable partial epilepsy, but even intracranial ictal recordings often reveal ill-defined onset zones in neocortical epilepsy. We studied the physiologic significance of ictal direct current (DC) potentials recorded intracranially in human epilepsy.Methods: We made intracranial ictal EEG recordings in three patients with intractable partial seizures arising from frontal, lateral temporal, and parietal neocortical areas by using closely spaced subdural electrodes (platinum in two patients and stainless steel in one patient) with both standard (1.5 Hz) and open (0.016 Hz) low-frequency filter (LFF) settings.Results: The initial ictal pattern was localized to two to nine subdural electrodes and characterized by very low voltage and high-frequency rhythmic activity (''electrodecremental pattern''). A slow-rising negative potential (DC potential) was seen in a slightly more restricted area (two to six electrodes) and occurred 1-10 s before the initial ictal EEG discharges in two patients,Conclusions: These results agree with those of previous studies of ictal DC shifts in animals and suggest that ictal DC shifts may be helpful in delineating the epileptogenic area more precisely in human epilepsy.