Matsuzaka T, Ono K, Baba H, Matsuo M, Tanaka S, Kamimura N, Tsuji Y
Department of Pediatrics, Nagasaki University School of Medicine, Sakamoto, Japan.
Epilepsia. 1999 Sep;40(9):1269-78. doi: 10.1111/j.1528-1157.1999.tb00857.x.
To clarify the relation between quantitative electroencephalogram (EEG) findings and outcome following corpus callosotomy (CC).
The degree of bilateral synchrony and morphologic similarity of spike-wave discharges was analyzed by using a cross-correlation analysis and the measurements of amplitude differences between bilateral homologous regions in 22 patients who underwent anterior CCs for intractable symptomatic generalized epilepsies (SGE; 17 patients) and frontal lobe epilepsy (five patients).
Interictal generalized synchronous spike-wave (GSSW) bursts in the SGE patients were disrupted and changed to unilateral spike-waves (USWs) in 11 patients and to bilaterally independent spike-waves (BISWs) in six. The USW group had better surgical outcome than the BISW group. Preoperatively, the USW group had significantly lower interhemispheric synchrony (IS) and fewer regional changes in the side leading in time and the side dominant for amplitude, suggesting unilaterally predominant epileptogenesis that triggered the secondary bilateral synchrony. Postoperatively, the BISW group had a more marked reduction in IS because of independent discharges from bilateral epileptogenic areas, and the USW group had a greater amplitude difference because of unilateralized spike-waves. In addition, an excellent surgical outcome was related to (a) the preoperative degree of the morphologic similarity of the bilateral spike-waves (only a small variation during a burst of spike-waves) and the few instances of regional changes in the side leading in time and in the side dominant for amplitude; and (b) to large postoperative amplitude differences.
Preoperative quantitative EEG analyses enabled us to predict the underlying conditions of epileptogenesis and the surgical outcomes in patients undergoing CC.
阐明胼胝体切开术（CC）后定量脑电图（EEG）结果与预后之间的关系。
采用互相关分析和测量22例因顽固性症状性全身性癫痫（SGE；17例）和额叶癫痫（5例）接受前胼胝体切开术患者双侧同源区域之间的振幅差异，分析棘波-慢波放电的双侧同步程度和形态相似性。
SGE患者发作间期全身性同步棘波-慢波（GSSW）暴发在11例患者中被破坏并转变为单侧棘波（USW），6例转变为双侧独立棘波（BISW）。USW组手术效果优于BISW组。术前，USW组半球间同步性（IS）显著较低，在时间领先侧和振幅占主导侧的区域变化较少，提示单侧优势的癫痫发生触发了继发性双侧同步。术后，BISW组由于双侧致痫区的独立放电，IS降低更为明显，而USW组由于棘波单侧化，振幅差异更大。此外，良好的手术效果与（a）双侧棘波形态相似性的术前程度（棘波暴发期间仅有微小变化）以及时间领先侧和振幅占主导侧区域变化的实例较少有关；（b）与术后较大的振幅差异有关。
术前定量脑电图分析使我们能够预测接受CC手术患者的癫痫发生潜在情况和手术效果。
