Clinical relevance of quantified intracranial interictal spike activity in presurgical evaluation of epilepsy
Clinical relevance of quantified intracranial interictal spike activity in presurgical evaluation of epilepsy
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DOI：
10.1111/j.1528-1157.2000.tb00191.x
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发表时间：
2000-04-01
期刊：
影响因子：
5.6
通讯作者：
Elger, CE
中科院分区：
文献类型：
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作者：
Hufnagel, A;Dümpelmann, M;Elger, CE
目的：回顾性分析32例经颅电极记录的难治性癫痫发作患者的脑皮质电图。目的是评估间歇峰的定量分析是否可以用于描述癫痫区。方法：我们使用新开发的计算机程序自动检测间隔尖峰和平均程序。这样就可以确定每个峰簇的最早峰，最大平均峰幅，最高峰值峰频率，以及每个记录点的最短平均峰持续时间。结果：(a)在离发作部位小于等于2 cm的区域内，我们定位了32例患者中27例（84%）的峰簇平均最早峰，24例（75%）的峰簇平均振幅最高，22例（69%）的峰簇平均持续时间最短，17例（53%）的峰簇频率最高；(b)刺突的发生与组织病理学无相关性；(c)没有证据表明，在多叶或双脑出现尖峰簇的患者中，术后癫痫控制降低。结论：最早的尖峰区和癫痫发作的起源显示出高度的相关性，有利于共同的癫痫发作源。为了控制癫痫发作，没有必要切除所有表现出尖峰簇的脑区。间歇尖峰活动的量化是定位癫痫发作源的一个有价值的工具。
Purpose: Electrocorticograms of 32 patients with medically intractable seizures, recorded through intracranial electrodes, were retrospectively analyzed. The objective was to assess whether quantitative analysis of interictal spikes may be used for delineation of the epileptogenic zone.Methods: We used a newly developed computer program for automatic detection of interictal spikes and averaging procedures. This allowed determination of the earliest spike of each spike cluster, the maximal averaged spike amplitude, the high est spike frequency, and the shortest averaged spike duration at each recording site.Results: The following results were obtained: (a) Within a zone less than or equal to 2 cm from the site of seizure origin, we localized the averaged earliest spike of a spike cluster in 27 (84%) of 32 patients, the highest averaged spike amplitude in 24 (75%) of 32, the shortest averaged spike duration in 22 (69%) of 32, and the maximal spike frequency in 17 (53%) of 32; (b) No correlation was found between spike occurrence and histopathology; (c) No evidence was found for decreased postoperative seizure control in patients with several multilobar or bihemispheric occurrence of spike clusters.Conclusions: The zones of the earliest spike and seizure origin demonstrate a high correlation that favors a common epileptic generator. Removal of all brain areas demonstrating spike clusters is unnecessary to achieve seizure control. Quantification of interictal spike activity is a valuable tool for localization of the seizure generator.