Localization of epileptogenic zone in temporal lobe epilepsy by ictal scalp EEG
Localization of epileptogenic zone in temporal lobe epilepsy by ictal scalp EEG
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发作期头皮脑电图定位颞叶癫痫致痫区
DOI：
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发表时间：
2002
期刊：
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通讯作者：
T. Morioka
中科院分区：
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作者：
Yuzo Sakai;Hiromi Nagano;A. Sakata;S. Kinoshita;N. Hamasaki;F. Shima;T. Morioka
目的：评价发作期头皮脑电图（EEG）对颞叶癫痫（TLE）致痫灶定位的能力。采用同步录像，我们分析了38例患者（30例内侧TLE（MTLE）和8例外侧TLE（LTLE））发作期的头皮EEG活动。其中14例用深部电极记录颅内发作期脑电图，11例同时记录头皮和颅内脑电图。头皮脑电图显示，在所有30例MTLE患者（72次发作中的71次）中，在发作活动出现之前观察到背景活动的衰减。在颅内脑电图上，当发作性放电到达颞叶外侧部时，首先在头皮脑电图上出现发作性放电。然而，在所有8例LTLE患者（25/25次癫痫发作）中，背景活动的衰减在发作活动出现之前并未发生。当颅内EEG上的发作性放电起始于外侧颞叶时，头皮上也出现了发作性放电。MTLE和LTLE可通过在发作放电出现前伴临床发作体征的背景活动衰减的存在或不存在来诊断。
Our aim was to evaluate the ability to localize the epileptogenic zone in temporal lobe epilepsy (TLE) by ictal scalp electroencephalogram (EEG). Using simultaneous video recording, we analysed scalp EEG activity during ictal periods in 38 patients (30 patients with medial TLE (MTLE) and eight with lateral TLE (LTLE)). In 14 patients, intracranial ictal EEGs were recorded with depth electrodes, and simultaneous recordings of scalp and intracranial EEG were performed in 11 patients. Scalp EEG showed that, in all 30 patients with MTLE (71 of 72 seizures), an attenuation of background activity was observed before the appearance of ictal activity. Ictal discharges first appeared in the scalp EEG when the ictal discharges reached the lateral part of the temporal lobe on the intracranial EEG. While, in all eight patients with LTLE (25 of 25 seizures), the attenuation of background activity did not occur before the appearance of ictal activity. When the ictal discharges started in the lateral temporal lobe on intracranial EEG, ictal discharges appeared on the scalp. MTLE and LTLE could be diagnosed by the presence or absence of attenuation of background activity with clinical ictal signs before the appearance of ictal discharges.