Inoue Y, Fukao K, Araki T, Yamamoto S, Kubota H, Watanabe Y
National Epilepsy Center, Shizuoka Higashi Hospital, Urushiyama, Japan.
Epilepsia. 1999;40 Suppl 4:8-16. doi: 10.1111/j.1528-1157.1999.tb00900.x.
To disclose possible epileptologic differences between photosensitive and nonphotosensitive patients with seizures induced by electronic screen games (ESGs).
In patients with ESG-induced seizures who showed photo- and pattern sensitivity, magnetoencephalography (MEG) and EEG were performed simultaneously during ESG play, and equivalent current dipoles (ECDs) of the MEG spikes were estimated. In patients without ESG-induced seizures, who were surgical candidates, the intracranial EEG was analyzed for changes in epileptiform spike frequency.
Fifteen of 29 patients were photo- or pattern sensitive, and they had a posterior predominance of ECDs of the MEG spikes. In contrast, nonphotosensitive patients had an anterior predominance of ECDs. Other seizure-precipitating factors in the nonphotosensitive patients included hand manipulation or spatial processing. In patients without a history of ESG-induced seizures who underwent intracranial EEG monitoring for surgical evaluation, ESG playing induced changes in spike frequency in the supplementary motor area, perisylvian region, and medial temporal lobe.
In photosensitive patients, interictal MEG spikes arise predominantly from the posterior region of the brain. In nonphotosensitive patients, epileptiform spikes tend to originate in the anterior part of the brain. Thus factors involving functions of the anterior part of the brain other than photo- or pattern sensitivity may play a role in the induction of seizures during ESG play. Furthermore, the changes in spike frequency in specific brain areas may correspond to their involvement in praxic activity and emotional changes during ESG play. A chance occurrence of seizures during ESG play also was observed.
揭示因电子屏幕游戏（ESG）诱发癫痫发作的光敏性和非光敏性患者之间可能存在的癫痫学差异。
对于表现出光敏感性和图形敏感性的ESG诱发癫痫发作的患者，在玩ESG期间同时进行脑磁图（MEG）和脑电图（EEG）检查，并估计MEG尖峰的等效电流偶极子（ECD）。对于没有ESG诱发癫痫发作但作为手术候选者的患者，分析颅内脑电图癫痫样尖峰频率的变化。
29例患者中有15例具有光敏感性或图形敏感性，他们的MEG尖峰的ECD在后部占优势。相比之下，非光敏性患者的ECD在前部占优势。非光敏性患者的其他癫痫诱发因素包括手部操作或空间处理。对于没有ESG诱发癫痫发作史且接受颅内脑电图监测以进行手术评估的患者，玩ESG会引起辅助运动区、颞周区域和内侧颞叶的尖峰频率变化。
在光敏性患者中，发作间期MEG尖峰主要起源于脑后部区域。在非光敏性患者中，癫痫样尖峰往往起源于脑前部。因此，除了光敏感性或图形敏感性之外，涉及脑前部功能的因素可能在ESG游戏期间癫痫发作的诱发中起作用。此外，特定脑区尖峰频率的变化可能与其在ESG游戏期间参与的实用性活动和情绪变化有关。还观察到在ESG游戏期间偶然发生癫痫发作的情况。
