Defining epileptogenic foci: Past, present, future
Defining epileptogenic foci: Past, present, future
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DOI：
10.1097/00004691-199711000-00003
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发表时间：
1997-11-01
影响因子：
2.4
通讯作者：
Ebersole, JS
中科院分区：
文献类型：
--
作者：
Ebersole, JS
皮层产生癫痫样放电的几何形状（位置、面积和方向）与头皮处产生的尖峰或癫痫发作电压场之间存在直接关系。传统上，通过EEG识别负场最大值（例如，相邻双极通道之间的相位反转）来定位致痫灶。然而，它是头部上方的整个电压场的形状，包括负最大值和正最大值，其提供了正确表征焦点所需的信息。源位置和方向可以从尖峰或癫痫发作电压地形推断，然而，三维可视化可以从数学源模型，如等效偶极子。最近的研究表明，偶极子模型可以识别致痫灶的位置与sublobar精度。通过使用额外的电极，特别是在头部的下半部分，并通过测量它们的位置来提高准确性。从MR图像的三维重建获得的真实头部模型可以克服由简单的颅骨球形模型引入的误差。将EEG电压地形图和源模型与患者自身的大脑解剖结构配准将使EEG成为用于定义致痫灶的无与伦比的功能成像技术。
There is a direct relationship between the geometry (location, area, and orientation) of cortex-generating epileptiform discharges and resultant spike or seizure voltage fields at the scalp. Epileptogenic foci have been localized traditionally with EEG by identifying the negative field maximum (eg, a phase reversal between adjacent bipolar channels). However, it is the shape of the entire voltage field over the head, including both negative and positive maxima, which provides information necessary to characterize the focus properly. Source location and orientation can be inferred from spike or seizure voltage topography, however, three-dimensional visualization can be obtained from mathematical source models, such as an equivalent dipole. Recent investigations have shown that dipole models can identify the location of epileptogenic foci with sub-lobar precision. Accuracy is enhanced by using additional electrodes, particularly on the lower half of the head, and by measuring their location. Realistic head models obtained from three-dimensional reconstructions of MR images can overcome errors introduced by simple spherical models of the cranium. Co-registering EEG voltage topography and source models with a patient's own cerebral anatomy will make EEG an unparalleled functional imaging technique for defining epileptogenic foci.