The Sensitivity of Scalp EEG at Detecting Seizures-A Simultaneous Scalp and Stereo EEG Study.
The Sensitivity of Scalp EEG at Detecting Seizures-A Simultaneous Scalp and Stereo EEG Study.
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DOI：
10.1097/wnp.0000000000000739
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发表时间：
2022-01-01
期刊：
影响因子：
--
通讯作者：
Fields MC
中科院分区：
文献类型：
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作者：
Casale MJ;Marcuse LV;Young JJ;Jette N;Panov FE;Bender HA;Saad AE;Ghotra RS;Ghatan S;Singh A;Yoo JY;Fields MC
比较头皮EEG与同步颅内立体EEG（SEEG）记录的癫痫发作检出率。27名接受SEEG的耐药性癫痫患者，同时进行头皮EEG作为其手术检查的一部分。共查获172起。在SEEG检测到的172次癫痫发作中，100次表现为头皮发作模式。与局灶性意识障碍（97%）和局灶性双侧强直阵挛性发作（100%）相比，局灶性意识障碍和亚临床发作在头皮上的发生率均为33%（P < 0.001）。在72例无发作头皮相关性的癫痫发作中，32例在SEEG癫痫发作期间表现出与发作间期异常相同的异常。与非病变患者相比，MRI病变患者的癫痫发作在头皮上出现的可能性在统计学上较低（P = 0.0162）。头皮上未见的立体EEG发作持续时间（49秒）短于头皮上可见的SEEG发作（108.6秒）（P < 0.001）。头皮EEG对于检测局灶性意识障碍和亚临床癫痫发作来说不是一种敏感的工具，但对于检测局灶性意识障碍和局灶性双侧强直阵挛性癫痫发作来说非常敏感。癫痫发作持续时间较长和无MRI病变的患者的癫痫发作更可能在头皮上明显。发作间期出现的癫痫有时可能代表潜在的癫痫发作。持续的难以检测的癫痫发作对认知、情感和行为的长期影响尚不清楚。
Compare the detection rate of seizures on scalp EEG with simultaneous intracranial stereo EEG (SEEG) recordings. Twenty-seven drug-resistant epilepsy patients undergoing SEEG with simultaneous scalp EEG as part of their surgical work-up were included. A total of 172 seizures were captured. Of the 172 seizures detected on SEEG, 100 demonstrated scalp ictal patterns. Focal aware and subclinical seizures were less likely to be seen on scalp, with 33% of each observed when compared with focal impaired aware (97%) and focal to bilateral tonic–clonic seizures (100%) (P < 0.001). Of the 72 seizures without ictal scalp correlate, 32 demonstrated an abnormality during the SEEG seizure that was identical to an interictal abnormality. Seizures from patients with MRI lesions were statistically less likely to be seen on scalp than seizures from nonlesional patients (P = 0.0162). Stereo EEG seizures not seen on scalp were shorter in duration (49 seconds) compared with SEEG seizures seen on scalp (108.6 seconds) (P < 0.001). Scalp EEG is not a sensitive tool for the detection of focal aware and subclinical seizures but is highly sensitive for the detection of focal impaired aware and focal to bilateral tonic–clonic seizures. Longer duration of seizure and seizures from patients without MRI lesions were more likely to be apparent on scalp. Abnormalities seen interictally may at times represent an underlying seizure. The cognitive, affective, and behavioral long-term effects of ongoing difficult-to-detect seizures are not known.