Generators and temporal succession of giant somatosensory evoked potentials in cortical reflex myoclonus: Epicortical recording from sensorimotor cortex
Generators and temporal succession of giant somatosensory evoked potentials in cortical reflex myoclonus: Epicortical recording from sensorimotor cortex
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DOI：
10.1016/j.clinph.2006.03.029
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发表时间：
2006-07-01
影响因子：
4.7
通讯作者：
Takahashi, Ryosuke
中科院分区：
文献类型：
--
作者：
Hitomi, Takefumi;Ikeda, Akio;Takahashi, Ryosuke
目的：阐明巨大体感诱发电位（giant SEPs）的产生机制以及初级体感和运动皮层（SI和MI）的高兴奋性。方法：对一例表现为左脚皮质反射性肌阵挛的顽固性局灶性癫痫患者，采用硬膜下电极记录左胫神经刺激的巨大sep，作为术前评估的一部分。结果：在单脉冲sep中，SI和MI足区P1-N1成分均增大（分别为86.5-258.8 mu V），且SI峰潜伏期始终比MI峰短6 ms。腓骨神经和腓肠神经刺激也得到了类似的结果。在配对脉冲sep中，与其他刺激间期（ISIs）相比，第二反应受到的抑制较小，在SI和MI时的ISIs分别为40和200 ms。结论：在该特殊患者中，皮层对体感觉刺激的高兴奋性似乎源于SI，但随后SI和MI都负责产生巨大的sep和皮质反射性肌阵挛。意义：体感和初级运动皮层都产生了增强的早期SEPs皮层成分，很可能是由前者增强后者。(c) 2006年国际临床神经生理学联合会。爱思唯尔爱尔兰有限公司出版。版权所有。
Objective: To clarify the generator mechanism of giant somatosensory evoked potentials (giant SEPs) and the hyperexcitability of primary somatosensory and motor cortices (SI and MI).Methods: In a patient with intractable focal seizures manifesting cortical reflex myoclonus of the left foot, giant SEPs to left tibial nerve stimulation were epicortically recorded as a part of presurgical evaluation with subdural electrodes.Results: In the single pulse SEPs, enlarged P1-N1 components were observed at the foot area of the SI and MI (86.5-258.8 mu V, respectively), and the peak latencies were always shorter at SI than at MI by 6 ms. Similar findings were obtained for peroneal and sural nerve stimulation. In the paired pulse SEPs, the second response was less suppressed, as compared to other interstimulus intervals (ISIs), with ISIs of 40 and 200 ms both at SI and MI.Conclusions: In this particular patient, cortical hyperexcitability to somatosensory stimuli seems to originate from SI but subsequently both SI and MI are responsible for the generation of giant SEPs and cortical reflex myoclonus.Significance: Somatosensory and primary motor cortices both generated enhanced early cortical components of SEPs, most likely by enhancing the latter by the former. (c) 2006 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.