Graduated and Sequential Propagation in Mesial Temporal Epilepsy: Analysis With Scalp Ictal EEG
Graduated and Sequential Propagation in Mesial Temporal Epilepsy: Analysis With Scalp Ictal EEG
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DOI：
10.1097/wnp.0b013e3181eaaa0e
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发表时间：
2010-08-01
影响因子：
2.4
通讯作者：
Orriols, Miguel A.
中科院分区：
文献类型：
--
作者：
Napolitano, Cayetano E.;Orriols, Miguel A.
本研究的目的是描述最常见的类型的放电传播内侧颞叶癫痫，并确定是否有特定的传播特性，表明程度较低的时间兴奋性。这是一项回顾性和分析性观察研究，对22例内侧颞叶癫痫患者进行了开放性历史队列研究，其中记录了75次复杂部分性癫痫发作，伴或不伴继发全身性发作。在75次发作中，64次发作为区域化-偏侧化发作，并分析了其距离传播顺序。确定了发病、定位和传播序列。根据癫痫发作传播将患者分为三组：I组（G I），仅传播至同侧半球; II组（G II），逐渐和顺序的同侧和对侧传播; III组（G III），全半球向对侧传播。与G III发作相比，G I和G II发作与单颞叶发作间期EEG显著相关（P = 0.00277）。同时，癫痫更容易控制在G I和II，而所有的G III患者是难治性的（P = 0.0094）。G I和G II患者比G III患者更倾向于单纯内侧硬化。观察到的大多数内侧颞叶癫痫发作显示，在放电开始时传播仅限于同侧半球或逐渐连续传播。一个较小程度的unitemporal兴奋性建议在这两种情况下，没有显着改变的同侧和对侧癫痫放电的传播时间和相对保存通常的传播途径。相反的情况下，建议对侧传播癫痫发作的患者。
The purpose of this study was to describe the most common types of discharge propagation in mesial temporal epilepsy and to determine whether there are particular propagation characteristics that suggest a lesser degree of temporal excitability. This is a retrospective and analytical observation study with an open historical cohort of 22 patients with mesial temporal epilepsy among whom 75 complex partial seizures were recorded, with or without secondary generalization. Of the 75 seizures, 64 were of regionalized-lateralized onset, and their distance propagation sequence was analyzed. The onset, localization, and propagation sequence were identified. The patients were classified into three groups according to seizure propagation: group I (G I), with propagation to the ipsilateral hemisphere only; group II (G II), with gradual and sequential ipsilateral and contralateral propagation; and group III (G III), with total hemisphere toward the contralateral propagation. The G I and G II seizures were significantly associated with unitemporal interictal EEGs in comparison with the G III seizures (P = 0.00277). At the same time, the epilepsy was easier to control in G I and II, whereas all the G III patients were intractable (P = 0.0094). The G I and II had a greater tendency to be patients with pure mesial sclerosis than the G III. Most of the mesial temporal seizures observed showed propagation limited to the ipsilateral hemisphere at the onset of the discharge or a graduated sequential propagation. A lesser degree of unitemporal excitability was suggested in both situations, without significant alterations in the propagation times of the ipsilateral and contralateral epileptic discharges and relative preservation of the usual propagation pathways. The reverse situation was suggested among patients with total contralateral propagation seizures.