Significance of interictal temporal lobe delta activity for localization of the primary epileptogenic region
Significance of interictal temporal lobe delta activity for localization of the primary epileptogenic region
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DOI：
10.1212/wnl.52.1.202
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发表时间：
1999-01-01
期刊：
影响因子：
9.9
通讯作者：
Gilliam, F
中科院分区：
文献类型：
--
作者：
Geyer, JD;Bilir, E;Gilliam, F
由于 30% 至 90% 的颞叶癫痫 (TLE) 患者存在发作间期颞叶 delta 活动 (TLDA)，但尚未在颞叶外癫痫患者中进行研究，因此我们试图确定 TLDA 的局部意义。我们比较了 47 名连续接受颞叶外切除术（40 名额叶切除术和 7 名顶枕叶切除术）治疗顽固性癫痫的患者与 43 名连续接受前颞叶切除术的患者的术前发作间期头皮脑电图结果。我们将侧化 TLDA 定义为低于 4 Hz 波形的运行，很容易与背景节律区分开，并且在电极 T4、F8 和 T6 或 T3、F7 和 T5 处达到最大值。侧化 TLDA 被细分为时间间歇性节律 delta 活动 (TIRDA) 或时间间歇性多态性 delta 活动 (TIPDA)。卡方检验用于确定致痫区叶与 TIRDA 和 TIPDA 的关联。我们在颞叶组中发现了 12 例 (28%) 患者的 TIRDA 和 8 例 (19%) 例患者的 TIPDA，在颞叶外组中发现了 2 例 (4%) 患者的 TIRDA 和 9 例 (19%) 患者的 TIPDA。 TIRDA 与 TLE 密切相关 (p < 0.003)，而 TIPDA 在两组中发生率相同。与颞前癫痫类似，高达 20% 的颞外癫痫患者存在侧向 TIPDA。 TIRDA 的存在强烈提示 TLE，但在颞外癫痫中可能很少发生。使用单侧 TLDA 作为术前定位发现时应谨慎。
Because interictal temporal lobe delta activity (TLDA) has been described in 30 to 90% of patients with temporal lobe epilepsy (TLE) but has not been investigated in patients with extratemporal epilepsy, we sought to determine the localizing significance of TLDA. We compared the presurgical interictal scalp EEG results of 47 consecutive patients who received extratemporal resection (40 frontal and 7 parietal-occipital) for intractable epilepsy with 43 consecutive patients who received anterior temporal lobectomy. We defined lateralized TLDA as runs of lower than 4-Hz waveforms that were easily distinguished from the background rhythms and were maximal at electrodes T4, F8, and T6 or T3, F7, and T5. The lateralized TLDA was subcategorized as temporal intermittent rhythmic delta activity (TIRDA) or temporal intermittent polymorphic delta activity (TIPDA). A chi-square test was used to determine the association of the lobe of the epileptogenic zone with TIRDA and TIPDA. We found TIRDA in 12 (28%) and TIPDA in 8 (19%) patients in the temporal lobe group, and TIRDA in 2 (4%) and TIPDA in 9 (19%) patients in the extratemporal group. TIRDA was strongly associated with TLE (p < 0.003), whereas TIPDA occurred at an equal rate in both groups. Similar to anterior temporal epilepsy, lateralized TIPDA is present in up to 20% of patients with extratemporal epilepsy. The presence of TIRDA strongly suggests TLE but may infrequently occur in extratemporal epilepsy. Caution should be used when using lateralized TLDA as a presurgical localizing finding.