Resection of ictal high-frequency oscillations leads to favorable surgical outcome in pediatric epilepsy.
Resection of ictal high-frequency oscillations leads to favorable surgical outcome in pediatric epilepsy.
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DOI：
10.1111/j.1528-1167.2012.03629.x
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发表时间：
2012-09
期刊：
影响因子：
5.6
通讯作者：
Rose DF
中科院分区：
文献类型：
--
作者：
Fujiwara H;Greiner HM;Lee KH;Holland-Bouley KD;Seo JH;Arthur T;Mangano FT;Leach JL;Rose DF
当无创测试不一致或推定的癫痫发作区靠近语言皮质时，进行颅内脑电图（EEG）作为癫痫手术评估的一部分。使用颅内脑电图确定癫痫发作区域传统上是基于通过目视检查识别特定的发作模式。最近人们认识到高频振荡（HFO，>80 Hz）与致痫区高度相关。然而，由于 HFO 振幅较低，因此很难检测到。因此，发作期 HFO 的患病率及其在颅内脑电图致癫痫区域定位中的作用尚不清楚。我们通过颅内脑电图进行手术评估后确定了 48 名接受手术治疗的患者，其中 44 名患者符合本回顾性研究的标准。结果不用于手术决策。以 2,000 Hz 的采样率收集颅内 EEG 记录。首先目视检查记录以确定发作发作，然后通过时频分析进一步分析。 44 名患者中的 41 名 (93%) 通过颅内 EEG 时频分析确定了发作性 HFO。 41 名发作性 HFO 患者中，有 22 名 (54%) 完全切除了 HFO 区域，无论频段如何。 22 名患者中，完全切除 HFO（n = 22）有 18 名患者（82%）实现无癫痫发作，显着高于不完全 HFO 切除的无癫痫发作结果（4/19，21%）。我们的研究表明，在我们的人群（主要是皮质发育不良的儿童）中，发作期 HFO 常见于颅内脑电图，并且具有定位价值。与发作间期 HFO 相比，发作期 HFO 的使用可能会增加更多有希望的信息，因为有发作期传播的证据以及癫痫发作的临床方面。 HFO 的完全切除是手术结果的有利预后指标。
Intracranial electroencephalography (EEG) is performed as part of an epilepsy surgery evaluation when noninvasive tests are incongruent or the putative seizure-onset zone is near eloquent cortex. Determining the seizure-onset zone using intracranial EEG has been conventionally based on identification of specific ictal patterns with visual inspection. High-frequency oscillations (HFOs, >80 Hz) have been recognized recently as highly correlated with the epileptogenic zone. However, HFOs can be difficult to detect because of their low amplitude. Therefore, the prevalence of ictal HFOs and their role in localization of epileptogenic zone on intracranial EEG are unknown. We identified 48 patients who underwent surgical treatment after the surgical evaluation with intracranial EEG, and 44 patients met criteria for this retrospective study. Results were not used in surgical decision making. Intracranial EEG recordings were collected with a sampling rate of 2,000 Hz. Recordings were first inspected visually to determine ictal onset and then analyzed further with time-frequency analysis. Forty-one (93%) of 44 patients had ictal HFOs determined with time-frequency analysis of intracranial EEG. Twenty-two (54%) of the 41 patients with ictal HFOs had complete resection of HFO regions, regardless of frequency bands. Complete resection of HFOs (n = 22) resulted in a seizure-free outcome in 18 (82%) of 22 patients, significantly higher than the seizure-free outcome with incomplete HFO resection (4/19, 21%). Our study shows that ictal HFOs are commonly found with intracranial EEG in our population largely of children with cortical dysplasia, and have localizing value. The use of ictal HFOs may add more promising information compared to interictal HFOs because of the evidence of ictal propagation and followed by clinical aspect of seizures. Complete resection of HFOs is a favorable prognostic indicator for surgical outcome.
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影响因子：
4.7
作者：
Gardner, Andrew B.;Worrell, Greg A.;Litt, Brian
通讯作者：
Litt, Brian
影响因子：
9.9
作者：
Hemb, M.;Velasco, T. R.;Mathern, G. W.
通讯作者：
Mathern, G. W.
影响因子：
11.2
作者：
Jacobs, Julia;Zijlmans, Maeike;Gotman, Jean
通讯作者：
Gotman, Jean
影响因子：
4.1
作者：
Goyal, Monisha;Robinson, Shenandoah
通讯作者：
Robinson, Shenandoah
DOI：
10.1016/0013-4694(93)90020-v
发表时间：
1993-10-01
期刊：
ELECTROENCEPHALOGRAPHY AND CLINICAL NEUROPHYSIOLOGY
影响因子：
--
作者：
GOTMAN, J;LEVTOVA, V;FARINE, B
通讯作者：
FARINE, B