INTRAHEMISPHERIC AND INTERHEMISPHERIC SPREAD OF CEREBRAL CORTICAL MYOCLONIC ACTIVITY AND ITS RELEVANCE TO EPILEPSY
INTRAHEMISPHERIC AND INTERHEMISPHERIC SPREAD OF CEREBRAL CORTICAL MYOCLONIC ACTIVITY AND ITS RELEVANCE TO EPILEPSY
复制标题
DOI：
10.1093/brain/114.5.2333
复制
发表时间：
1991-10-01
期刊：
影响因子：
14.5
通讯作者：
MARSDEN, CD
中科院分区：
文献类型：
--
作者：
BROWN, P;DAY, BL;MARSDEN, CD
9例皮质性肌阵挛（由于各种病理），其中一个肢体的运动引起双侧肢体抽搐，进行了研究。 其中3例患者在一侧肢体接受电刺激时也出现双侧皮质反射肌阵挛。 本文研究了同侧和对侧各肌在动作和反射性抽搐时肌电图活动的相对延迟时间，发现单侧电刺激或肢体运动引起的双侧反射和动作性抽搐是不同步的。 EMG活动通常记录在受刺激或移动肢体的肌肉中，然后记录在对侧肢体的同源肌肉中。 同侧肌肉相对潜伏期的差异反映了兴奋从一侧感觉运动皮层经胼胝体向另一侧大脑皮层传递的半球间延迟，同侧肌肉的相对潜伏期不仅反映了运动皮层经脊髓和周围神经传出延迟的差异，而且由于感觉运动皮层本身内的肌阵挛活动的扩散而延迟。 这种半球内的扩散遵循一种明显的躯体定位模式。 这表明，这种传播涉及皮质-皮质通路。 在第一活动半球，由于活动从感觉运动皮层的手到腿区域的传播而导致的额外延迟约为10 ms，包括全身反射和动作抽搐。 延迟由于在相反的后激活半球的活动的躯体位置的传播short.The倾向通过胼胝体和皮质-皮质通路的兴奋的传播是一个额外的病理生理异常，在一些患者的皮质肌阵挛，并可能是重要的在这些患者中看到的癫痫发作的泛化。
Nine patients with cortical myoclonus (due to various pathologies), in whom movement of one limb induced bilateral limb jerks, were investigated. Three of these patients also had bilateral cortical reflex myoclonus when one limb was subjected to an electrical stimulus. The relative latencies to onset of electromyogram (EMG) activity in various ipsilateral and contralateral muscles in action and reflex jerks were studied.Bilateral reflex and action jerks induced by unilateral electrical stimuli or limb movement were not synchronous. EMG activity was usually recorded in the muscles of the stimulated or moved limb, before being recorded in the homologous muscles of the contralateral limb. It is proposed that this difference in relative latency between homologous muscles represents the interhemispheric delay due to the transcallosal spread of excitation from one sensorimotor cortex to the opposite cerebral cortex.The relative latencies of muscles on the same side of the body reflected not only the differences in efferent delays from the motor cortex via spinal cord and peripheral nerves, but also delays due to the spread of myoclonic activity within the sensorimotor cortex itself. This intrahemispheric spread followed a grossly somatotopic pattern. It is suggested that this spread involves cortico-cortical pathways. The additional delay due to spread of activity from hand to leg area of the sensorimotor cortex was about 10 ms in the first active hemisphere, in both generalized reflex and action jerks. The delays due to somatotopic spread of activity in the opposite later activated hemisphere were shorter.The tendency for spread of excitation through callosal and cortico-cortical pathways is an additional pathophysiological abnormality in some patients with cortical myoclonus, and may be important in the generalization of seizures seen in these patients.